Quality of life, work ability and oral health among patients with chronic liver diseases.

BACKGROUND: This study aimed to explore the associations between health-related quality of life and work ability with the oral health status of patients with chronic liver disease. MATERIAL AND METHODS: A cross-sectional study included 150 patients with chronic liver disease, consecutively seen at University Hospital, Salvador, Brazil. Oral health was evaluated by the Decayed, Missing, and Filled Teeth (DMFT) index and by the presence of gingivitis and periodontitis. Salivary flow was "reduced" when <1.0 mL/min. Health-related quality of life was evaluated by using the 36-Item Short Form Health Survey questionnaire (SF-36); work ability was evaluated by the Work Ability Index questionnaire. RESULTS: All health-related quality of life indicators were systematically lower among the 99 patients with reduced salivary flow than among the 51 patients with normal salivary flow. Physical Functioning, Role-Physical, and Physical Component Summary scores were strongly correlated (P < 0.005 or less) with the number of Missing Teeth and with DMFT index. Reduced salivary flow was associated (P < 0.05) with poor work ability. Patients with poor or moderate work ability presented higher (P < 0.001) means of the DMFT index than those with good or excellent work ability. CONCLUSIONS: Patients with chronic liver disease who present poor oral health presented low health-related quality of life and poor work ability. These findings reinforce the need of these patients for specialized stomatological care.

The Effects of a 36-Hour Mixed Task Ultraendurance Race on Mucosal Immunity Markers and Pulmonary Function.

OBJECTIVE: The present study was conducted to assess the changes in mucosal immunity and pulmonary function among participants in a 36-hour mixed task ultraendurance race. METHODS: Thirteen of the 20 race participants volunteered for the investigation (age 34±5 y). The event consisted of a mixture of aerobic, strong man, and military-style exercise. Participants had a pulmonary function test and gave a finger stick capillary blood sample and unstimulated saliva samples both before the event and upon dropout or completion. The blood sample was analyzed for hematocrit, and the saliva sample was analyzed for salivary flow rate, salivary alpha amylase, salivary immunoglobulin A (IgA), and IgA type 1. RESULTS: Significant differences were noted among the finishers and those who dropped out in salivary flow rate (P = .026), salivary IgA (P = .017), and peak expiratory flow (P = .05) measurements. Salivary flow rate and IgA for the race finishers were reduced from pre- to postrace, whereas the nonfinishers showed no change or small increases. No significant differences emerged for other variables. CONCLUSIONS: Based on the results of the present investigation, finishing a 36-hour mixed task ultra-endurance event results in a decline in both pulmonary function and mucosal immunity compared with competitors who do not finish.

Musculoskeletal disorders and work ability among dentists and dental students in Finland.

BACKGROUND: Musculoskeletal disorders are leading causes for long sickness absences and early retirement. Dental work is physically strenuous, and many studies have shown a relation between work-related MSDs and dentistry. However, fewer studies have focused on how these conditions affect the work ability of dentists. OBJECTIVE: This study aimed to reveal the relationship between MSD, work ability and sickness absences in Finnish dentists and dental students. METHODS: A questionnaire was sent to 1200 dental workers and students. It inquired of age, gender, use of dental loupes, physical exercise, use of health care, and site, length and frequency of musculoskeletal complaints. Work ability was assessed with four parameters: work ability score (WAS), future work ability (FWA), self-estimation of MSD-related work disability, and sickness absence days. RESULTS: The questionnaire gained 255 responses (response rate 21%). The majority (90%) of the respondents had experienced MSD during the past year but only eleven percent of them had been on sick leave. MSDs correlated significantly with WAS, FWA and MSD-related work disability. Results remained significant even age adjusted. Age was a strong predictor of declined work ability, but gender, physical exercise or dental loupe use did not have a significant impact. CONCLUSIONS: Despite all the ergonomic advances in modern dentistry, the occurrence of MSD symptoms is still high. MSDs seem to affect dentists' work ability significantly, but amount of sickness absence is relatively low, which may indicate a high level of presenteeism.

No benefit adding eleutherococcus senticosus to stress management training in stress-related fatigue/weakness, impaired work or concentration, a randomized controlled study.

INTRODUCTION: Plant adaptogens are traditionally used for stress-related symptoms, but clinical evidence is inconsistent. This trial explored the effects of 120 mg/day Eleutherococcus senticosus root extract (ES), 2-day professional stress management training (SMT) and a combination of both (COM). METHODS: 144 participants suffering from asthenia and reduced working capacity related to chronic stress were randomized to the treatments. Validated scales and tests were used to investigate cognitive performance; feeling stressed; fatigue and exhaustion; alertness, restlessness and mood; quality of life and sleep; physical complaints and activities; and physiological stress parameters including cortisol awakening response (CAR), at baseline, after 2 and 8 weeks of treatment (German Clinical Trials Register DRKS00000692). RESULTS: Almost all parameters improved significantly over time without group differences. Significant differences were found in mental fatigue and restlessness, both in favor of COM vs. ES. COM was not superior to SMT in any parameter at week 8. An attenuation of the CAR was seen at week 2 without group differences. All treatments were well tolerated. DISCUSSION: Effects of adding ES to SMT are, if any, negligible.

Effectiveness of participatory ergonomic interventions on musculoskeletal disorders and work ability among young dental professionals: A cluster-randomized controlled trail.

OBJECTIVES: This study is to evaluate the efficacy of participatory ergonomic (PE) intervention on musculoskeletal disorders (MSDs) and work ability among young dental professionals in China. METHODS: A cluster randomized controlled trail was conducted during 2015-2016. Twenty-nine departments from five hospitals in the South of China were randomized into intervention (14 departments) and control (15 departments), with individuals of 125 and 138 dental professionals, respectively. Main participatory ergonomic interventions involved work posture, repetitive motions, tool usage, work break relaxation and work time re-arrangement with total 235 ergonomic changes in the trail. Individual ergonomic risk exposure was assessed by investigator's observation using quick exposure check (QEC). Work ability index (WAI) and MSDs were collected by questionnaires at baseline, and every 3 months during the 1-year follow-up. RESULTS: Follow-up rate was 91% and 96% for the intervention and control group, respectively. Significant reductions in ergonomic risk exposure and MSD prevalence on six anatomic sites were found in the PE group during the different follow-up stages. WAI scores improved by 1.1 (95% CI 0.43, 1.89) after the 9-month intervention. Compared to the control, the PE participants significantly reduced MSDs on neck (OR = 2.93, 95% CI: 1.25, 4.03) and wrists/hands (OR = 2.33, 95% CI: 1.08, 4.21), marginally increased WAI scores by 0.53 (95% CI: -0.02, 1.56) due to the interventions. CONCLUSION: PE intervention is effective in reducing ergonomic risk exposure and MSDs on neck and wrists/hands among young dental professionals. PE ought to be offered in the early dental career for preventing MSDs.

An evaluation of U.S. Navy Dental Corps classification guidelines.

OBJECTIVES: The aims of this research were to evaluate the effectiveness of two different sets of dental classification guidelines to differentiate dental emergency (DE) rates between deployable and nondeployable personnel. METHODS: A retrospective study of the dental records of two cohorts of Marine Corps recruits examined and treated using different classification guidelines was completed. RESULTS: Both classification systems showed significant differences between DE rates of nondeployable and deployable personnel. No statistical difference was observed when comparing the adjusted HRs of the two cohorts. CONCLUSIONS: Results of this study suggest that both guidelines are able to distinguish between deployable and nondeployable personnel and give reasonable assurance that class 1 and 2 patients will not experience a DE for a 6-month period. Incorporating factors such as caries risk, number of missing and filled teeth, and number of third molars may improve the ability of the dental classification systems in predicting DE.

[Biologic age as a criterion for work evaluation (exemplified by titanium alloys production)].

The article deals with results of studies concerning biologic age of workers (males) under occupational hazards of titanium alloys (jeopardy classes 3.3, 3.4.4) in Verkhne-Saldinsky metallurgic production association. Based on mathematic statistic analysis, the authors worked out an equation of multiple regression for ageing pace to forecast the ageing with consideration of age, length of service, occupation. The authors determined occupational groups characterized by premature ageing and increased risk of health disorders.

The Effects of Noise and Heat Strain on the Work Ability Index (WAI) among Rubber Factory Workers.

INTRODUCTION: Assessing the work ability and factors affecting it is essential in developing strategies for preventing damages and managing risks. This study aimed to investigate the simultaneous effect of noise level and physiological strain as well as individual characteristics on the work ability. METHOD: The population in this cross-sectional study included workers of a rubber factory. The TES noise dosimeter was used to examine individual exposure and the electro polar RS100 was used to measure physiological strain index (PSI). Individual characteristics and the work ability index were evaluated using the WAI questionnaire and analyzed using SPSS version 19. chi-square test, pearson correlation coefficient, and one-way and multiple ANOVA were used for data analysis. RESULTS: The final modeling showed that age, exercising period, Equivalent Continuous Sound Pressure Level (Leq), PSI and employment status had significant correlations with the work ability index (p < 0.05). The modified r2 for the obtained model was also calculated to be 0.483. DISCUSSION AND CONCLUSION: Based on the findings, number of exercising hours, employment status, age, Leq, and psi are among the factors affecting the work ability index. Use of management and engineering controls are recommended to balance work environments exposed to noise and heat and improve the work ability index. Further, improving employment status due to creating a sense of stability and reducing stress as well as enhancing lifestyle quality can be effective in increasing the work ability index.

Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial.

BACKGROUND: This prospective, clinical, randomized, double-blind study was intended to investigate the impact of the structure and the amount of polypropylene (PP) mesh used in laparoscopic transabdominal preperitoneal hernioplastic (TAPP) on physical function and life quality. METHODS: 180 male patients with primary inguinal hernia undergoing TAPP were randomized for using a heavyweight (108 g/m(2)), double-filament PP mesh (Prolene, 10 x 15 cm, group A, n = 60), a multifilament, heavyweight variant (116 g/m(2)) of PP mesh (Serapren, 10 x 15 cm, group B, n = 60), or a composite mesh (polyglactin and PP) (Vypro II, 10 x 15 cm, group C, n = 60). We compared in terms of complications (seromas, recurrence rate) and life quality (pain development, physical function). The development of life quality was documented according to the SF-36 Health Survey. The follow-up period was 60 months. RESULTS: The recurrence rate (2.2% overall) during 60-month follow-up was not significantly different between the groups. Convalescence in group A was slower than in groups B and C: mean-term values of the visual scales for pain development were significantly (p < 0.05) higher, incapacity for work was 8.2 days longer, and urological adverse effects were stronger. The mean-term development of life quality was significantly lower in group A up to 12th week postoperatively. There were no significant differences between groups B and C. Beyond the 12th postinterventional week the differences diminished. CONCLUSIONS: The composite mesh does not provide an advantage concerning physical function or pain development in comparison to the multifilament, heavyweight, pure polypropylene mesh. Independently of which mesh was implanted 5% of patients are still suffering from discomfort after 5 years.

Validity and reliability of the Disabilities of Arm, Shoulder, and Hand scale in dental students: A transnational study.

This study aimed to evaluate the validity and reliability of the Disabilities of Arm, Shoulder, and Hand (DASH) scale in Brazilian and American dental students and assess the influence of demographic variables on disability in them. A cross-sectional observational study was conducted with a nonprobabilistic sample. The sample was composed of students of both genders from the School of Dentistry of Araraquara, State University of São Paulo (UNESP) (n = 288), and students from Stony Brook University, New York, NY, USA (n = 149). The disabilities of the upper limbs were estimated using the DASH scale. The samples were characterized by collecting information on gender, academic year, and sports and work activities. The refined bifactorial model presented goodness-of-fit indices for both countries. There was a significant effect of the variables gender and academic year for the Brazilian sample and the variable sports practices for the American sample. The refined bifactorial model was valid and reliable for the Brazilian and American populations. In this model, the removal of item 17 for the Brazilian sample and items 3, 13, and 23 for the American sample was necessary. Demographic variables such as gender, academic year, and sports practice contributed significantly to the level of disability in the study populations.

Assessment of work compatibility across employees' demographics: a case study.

'Work compatibility' (WC) is a multi-dimensional diagnostic tool for measuring human performance that affects safety performance of work force. There are a dearth of literature on the use of WC in industrial applications. In this study, the status of WC and its components across employees' demographics such as age, experience, designation and location of work were examined in a steel plant in India. Data on 119 employees collected using Demand-Energizer Instrument was analysed. The results revealed that supervisors perceive higher energizers, higher demands and low WC as compared to workers. Older and high experience employees perceive higher energizers, lower demands and high WC as compared to younger and less experienced employees. All employee groups perceive higher demand for physical environment and physical task content. The problematic work groups identified are less experienced employees and workers in 'allied sections'. The outcomes of the study help the management in three ways to improve human performance at work places: (i) it provides useful information about the work factors to be considered for intervention design, (ii) it identifies the work groups to be targeted while preparing intervention strategies and (iii) it can be used as a leading indicator of human performance.

Inguinal hernias: value of preparticipation examination, activity restriction decisions, and timing of surgery.

Though groin pain is common, the differential diagnosis is broad, and narrowing down the diagnosis of an inguinal hernia can be challenging. Once a hernia is diagnosed, play becomes limited based on severity of symptoms and physician and patient comfort, and the athlete should be closely monitored for worsening symptoms. Several surgical approaches are available for the repair of inguinal hernias, but without knowing the true natural history of this disorder, it is difficult to know when it is appropriate to have a hernia repaired.

Pericarditis: diagnosis, management, and return to play.

In athletes who present to their team physician with complaints of chest pain, the diagnosis of pericarditis should be entertained. Although generally self-limited, potential complications include cardiac tamponade and recurrent pericarditis. The typical scenario is of an athlete who had a recent viral upper respiratory illness and now presents with chest pain, friction rub, and characteristic electrocardiographic changes. Additional recommended testing includes complete blood count, erythrocyte sedimentation rate and/or C-reactive protein, cardiac enzymes, chest radiographs, and echocardiogram with Doppler. During acute pericarditis, participation in athletics is contraindicated. Return to play is permissible after there is no longer evidence of active disease. This is confirmed by the absence of effusion on echocardiography and normalization of serum markers of inflammation.

Lower respiratory infections and potential complications in athletes.

A review and synthesis of recently published literature regarding lower respiratory infections in athletes was conducted. Diagnosis and treatment of common etiologies, specifically acute bronchitis, pneumonia, and influenza, are examined and discussed. In addition, potential complications, including spontaneous pneumothorax, bronchiectasis, hemoptysis, and acute respiratory failure that may result from inadequate diagnosis and treatment, are addressed. Criteria for allowing athletes to return to play were reviewed and current accepted guidelines for return to activity are discussed.

Fitness for work in difficult cases: an occupational medicine experience in a University Hospital.

BACKGROUND: Fitness for work (FW) in certain clinical cases poses significant professional challenges for Occupational Physicians (OPs). OBJECTIVES: to discuss the role of a public Institute of Occupational Medicine (IOM) in FW, thorough description of clinical cases. METHODS: the IOM at the University of Brescia is a public clinic available to general practitioners, OPs, other specialists, insurance companies, health authorities, employers, trade unions. IOM expert opinion on FW may be requested by OPs, employers or workers. In each case, occupational and clinical histories are taken, physical examinations, laboratory and instrumental tests might be performed, and technical and clinical documentation is acquired; expert opinions from other specialists might also be sought. Risk assessment (RA) stems from worksite inspections and information from company health and safety representatives, or health authorities. RESULTS: a few peculiar clinical cases are reported: tremors in a dental hygienist trainee, chorioretinitis in a welder, spasmofilia in a nursing aide, obstructive sleep apnoea in a steel worker, epilepsy in a metal engineering worker, as well as a number of cases fom the same workplace. CONCLUSIONS: FW judgement made by a IOM had several advantages from clinical and RA aspects. Work restrictions may not always be evidence based and it might be difficult to balance rights and duties of patients, employers and OPs; the IOM's wider experience, case discussion with the relevant parties, scientific and technical documentation of diagnostic and FW processes, strengthen the role of the IOM in dealing with difficult cases and as a guarantee from technical and ethical viewpoints.

Alterações posturais e capacidade para o trabalho em acadêmicos do curso de odontologia de uma instituição de ensino superior privada no sertão central cearense / Postural changes and work ability of dentistry students in a private higher education institution in the state of Ceará, Brazil

A profissão exerce influência nas condições de saúde dos trabalhadores, por isso algumas práticas no trabalho exigem cuidado. Durante a realização das práticas odontológicas, os acadêmicos e profissionais adquirem posições estáticas desconfortáveis e inadequadas por períodos de longa duração. O objetivo deste estudo foi avaliar as condições posturais e a capacidade para o trabalho em graduandos do curso de Odontologia do Centro Universitário Católica de Quixadá/CE. Trata-se de um estudo transversal, descritivo e exploratório, com abordagem metodológica quantitativa. A população constituiu-se de 147 alunos do curso de Odontologia da Unicatólica, de ambos os gêneros, no período de 2019.2 a 2020.1. A coleta de dados deu-se por meio do Índice de Capacidade para o Trabalho, e da avaliação postural através do Instrumento de Avaliação Postural, com o auxílio do simetrógrafo. Observou-se que desvios posturais estavam mais presentes no gênero feminino, podendo se explicar pelo seu número mais expressivo, porém não foram detectáveis relações entre a capacidade para o trabalho e as alterações posturais. Foi possível concluir que mesmo com o quantitativo de alterações posturais dos estudantes, apresentavam boa capacidade para o trabalho. (AU)

The profession influences the health conditions of workers, so some practices at work require specific care. During the performance of dental practices, students and professionals acquire uncomfortable and inappropriate positions for long periods. The aim of this study was to evaluate postural conditions and work ability in undergraduate students of the Dentistry course at the Centro Universitário Católica de Quixadá/CE, Brazil. This was a cross-sectional, descriptive, and exploratory study, with a quantitative methodological approach. The population consisted of 147 students from the Unicatólica Dentistry course, of both genders, in the period from 2019.2 to 2020.1. Data collection took place through the Work Ability Index, and the postural assessment through the Postural Assessment Instrument, with the aid of the symmetrograph. Postural deviations were more present in the female gender, which can be explained by their more expressive number, but no relationships were detected between work ability and postural changes. It was possible to conclude that even with the number of postural changes in the students, they had a good capacity for work. (AU)

Current thinking: return to play and transient quadriplegia.

Athletes that participate in contact and collision sports assume risk of serious injury each time they take the field. For those athletes that have sustained an episode of transient quadriplegia, the decision of whether to return to competition can be a difficult one. Some athletes, realizing how close they may have come to permanent injury, may decide that further participation is not in their best interest. Others may be somewhat undecided, and some may want to return at all costs. As the treating physician, the goal is to identify those athletes who after a single episode of transient quadriplegia are at increased risk for further injury and consequently should discontinue participation in contact sports. Factors that may contribute to that determination include mechanism of injury, prior history of neurologic symptoms or injury, and anatomic features that may predispose to further injury such as disc herniation, fracture, or cervical stenosis.

International classification of functioning in professional rehabilitation: instruments for assessing work disability / Classificação internacional de funcionalidade na reabilitação profissional: instrumentos de avaliação da incapacidade laboral

ABSTRACT OBJECTIVE To review the main instruments of functional assessment and health status cited in the literature to evaluate Brazilian workers and verify the compatibility of their items with the core set for professional rehabilitation. METHODS A review of the literature was conducted in the main databases in search of articles that used assessment instruments in populations of workers between 2007 and 2017. Subsequently, the contents of the identified instruments were retrieved, and two evaluators analyzed their items to verify the compatibility with the categories of the core set of the International Classification of Functioning for professional rehabilitation. Cohen's kappa coefficient was used to evaluate the agreement between the evaluators. RESULTS Five specific and eight generic instruments were selected to evaluate the functioning of workers. The analysis of the items of the total instruments allowed the definition of 58 categories (64.5%) of the core set with minimal overlap: 13 (76.5%) of the body functions component, 29 (72.5%) of the activities and participation component and 16 (49%) environmental factors. CONCLUSIONS The association of several instruments requires time and makes it difficult to use the classification. The development of instruments with direct association with its categories is essential to operationalize it.

RESUMO OBJETIVO Revisar os principais instrumentos de avaliação funcional e situação de saúde citados na literatura para avaliar trabalhadores brasileiros e verificar a compatibilidade de seus itens com o core set para reabilitação profissional. MÉTODOS Foi realizada uma revisão da literatura nas principais bases de dados em busca de artigos que utilizaram instrumentos de avaliação em populações de trabalhadores entre 2007 e 2017. Posteriormente foram recuperados os conteúdos dos instrumentos identificados e dois avaliadores analisaram seus itens para verificar a compatibilidade com as categorias do core set da Classificação Internacional de Funcionalidade para reabilitação profissional. O coeficiente kappa de Cohen foi utilizado para avaliar a concordância entre os avaliadores. RESULTADOS Foram selecionados cinco instrumentos específicos e oito genéricos que avaliaram a funcionalidade de trabalhadores. A análise dos itens do total de instrumentos permitiu o preenchimento de 58 categorias (64,5%) do core set com o mínimo de sobreposição: 13 (76,5%) do componente funções corporais, 29 (72,5%) do componente de atividades e participação e 16 (49%) de fatores ambientais. CONCLUSÕES A associação de vários instrumentos requer tempo e dificulta o uso da classificação. A elaboração de instrumentos com associação direta às suas categorias se faz essencial para operacionalizá-la.

Classification of municipal occupations.

Eighty-eight job titles were analyzed with the "ergonomic job analysis procedure" [Arbeitswissenschaftliche Erhebungsverfahren zur Tätigkeits-analyse abbreviated (AET) in German]. The objective was to classify the wide range of municipal jobs into homogeneous groups according to job demand and to provide better possibilities to study the relationships between work and health among the aging municipal working population. Altogether 216 items were classified. First, a hierarchical cluster analysis was made, and a dendrogram of the analyzed job titles was drawn. Second, a profile analysis was done in which the single items were grouped into 39 sum items, and a graphic profile was drawn. Finally, the stress factors were listed and drawn in ranking order. The cluster analysis formed 13 groups. Groups exposed to the highest stress factor level were kitchen supervisors, dentists, and physicians. More than 10 stress factors (greater than 50% of the maximum) were found in nursing, administration, installation, transport, and technical supervision.

Class 3 dental treatment time.

OBJECTIVE: Dental emergencies take soldiers away from their assigned duties. The objective of this project was to determine the average clinical treatment time needed to correct nondeployable dental conditions using actual treatment times noted in an electronic scheduler. METHODS: The Fort Hood Class Three Intercept Clinic forwarded their daily treatment logs to the Dental Command for each week from November 1, 2002 through February 13, 2003. Clinical treatment times and types of services provided for dental fitness category (DFC) 3 conditions were tracked with the Corporate Dental Application scheduler. RESULTS: The project identified 398 DFC 3 soldiers who were scheduled to receive treatment at the Fort Hood Class Three Intercept Clinic between November 1, 2002 and February 13, 2003. Twenty-three of those soldiers did not receive treatment; therefore, the total sample size was 375. On average, it required 2.2 hours of clinical dental treatment time to make a DFC 3 soldier dentally deployable. CONCLUSIONS: The findings of this study suggest that treating DFC 3 conditions is time-intensive but most DFC 3 soldiers can be treated in approximately 2 hours in an efficient and properly staffed dental clinic. Without proper preventive education and maintenance, these soldiers may develop additional oral disease and may require repeated episodes of increasingly intensive dental treatment.