Fluid and electrolyte balance following consumption of skimmed milk and a plant-based soya beverage at rest in euhydrated males.

PURPOSE: Cow's milk is one of the most hydrating beverages, but many individuals choose not to consume dairy in their diet due to intolerance, allergy, or dietary preference. Milk is commonly replaced with plant-based beverages, including soya which has the most comparable protein content, but little is known about their hydration potential. This study compared fluid and electrolyte balance responses between a soya beverage and skimmed cow's milk. METHODS: Ten healthy males [age 27 (6) y; body mass index 24.6 (2.3) kg/m2] completed two randomised counterbalanced trials, involving consuming 1000 mL water from approximately isocaloric amounts of skimmed cow's milk (MILK) or a sweetened soya beverage (SOYA), in four aliquots over 30 min in a euhydrated fasted state. Volume, specific gravity, and electrolyte (sodium, potassium, chloride) concentrations were determined in total-void urine samples collected pre-/post-beverage ingestion, and hourly for 180 min thereafter. Hunger, thirst, nausea and stomach fullness were rated proximal to urine samples. RESULTS: Total urine mass (MILK, 986 ± 254 g; SOYA, 950 ± 248 g; P = 0.435) and urine specific gravity (P = 0.156) did not differ between trials. Potassium balance was greater in SOYA 0-180 min post-beverage (P ≤ 0.013), whilst chloride balance was greater in MILK 0-120 min post-beverage (P ≤ 0.036). Sodium balance (P = 0.258), total electrolyte balance (P = 0.258), and subjective measures (P ≥ 0.139) were not different between trials. CONCLUSION: Replacing cow's milk with a soya beverage did not negatively impact fluid balance in healthy young males, making it a viable option for those who choose not to consume dairy in their diet.

"A good way to start the day": UK-based parents' views about offering vegetables to children for breakfast.

Children in the UK do not eat enough vegetables for optimal health and development; therefore, considering methods to increase children's vegetable intake is critical. Currently, if UK children are offered vegetables to eat, this typically occurs at midday/evening meals, and/or for snacks - children are seldom offered vegetables at breakfast time, even though there is no medical, nutritional, or physiological reason not to. Therefore, this study aimed to explore the views and experiences of parents in relation to offering children (aged 18 months to four years) vegetables to eat at breakfast time. Semi-structured interviews were conducted with 18 parents (aged 27-51 years) who were asked for their opinions about offering vegetables to children at breakfast time, and about their perceptions of their child(ren)'s behaviours in relation to vegetables at breakfast. A thematic analysis of the data identified the following themes/sub-themes relating to parents' views and experiences: 1) willingness - there was widespread willingness amongst parents to offer their chid(ren) vegetables at breakfast time; 2) barriers - relating to social/behavioural norms (parent/family and societal), practical challenges, and vegetables being commonly disliked by children; 3) facilitators - relating to young children not yet having developed social norms around foods, various practical solutions, and the need for information and awareness campaigns to highlight how and why vegetables can be incorporated into children's breakfasts. These encouraging findings for optimising children's health via this novel approach suggest that further research and dissemination around the value of offering children vegetables for breakfast is required.

"I see it very much as an end-of-life food" - Barriers to oral nutritional supplement adherence, views from healthy older adults.

Malnutrition affects approximately one quarter of UK adults aged 65 years and over. As the global demographic shift continues, malnutrition is expected to increase. Oral nutritional supplements (ONS) are used both to prevent and to treat malnutrition. However, their effectiveness is compromised by poor adherence, and it is not well understood what contributes to this. Therefore, the current research was designed to explore ONS adherence from the parallel perspectives of ONS as a prescribed "medication" and as a food supplement/substitute. Eighteen older adults (13F, 5M; mean age = 73.4 yr; range: 70-80 yr) participated in focus groups (three in-person and one online), to investigate experiences of taking prescribed medications, including dietary supplements, and what should be factors to consider in supporting regular intake of ONS for trial development, as well as any potential improvements to products. Focus group sessions were recorded and then transcribed. Thematic Analysis was applied to the transcripts by the first author, and themes were discussed in depth, using exemplar quotes from participants. Five dominant themes were identified from the data: Disgust, Palatability and Acceptance; End-of-Life Care; Resistance to Medicines; Rituals and Reminders; and Real Food Displacement. Nutritional supplements were characterised as "disgusting", "manufactured", and associated with serious, chronic illness, as well as end-of-life care, in contrast to probiotics which were linked with health and wellness. The sweet taste of ONS was identified as a barrier to intake, given that it is generally associated with a signal to stop eating, and low hunger. As a group, participants tried to "avoid taking medicines", and viewed the need to have them negatively, yet most regularly took prescribed medication and/or vitamin supplements. Participants identified several, rituals and reminders to take medicines, including meal-based, or time-of-day-based prompts (e.g., before, with or after meals). To improve adherence, savoury products were suggested, as well as a more person-centred approach to individual nutritional needs and preferences. Overall, the group discussion mainly identified barriers to intake, but that improving taste, adding to "real food" (not replacing meals), and offering variety of flavour and form (e.g., savoury soups as well as sweet drinks) could be included in future trials to improve appeal and therefore intake. Future work should continue to explore how best to formulate, market and/or prescribe ONS, and how this might vary for malnutrition prevention vs treatment strategies.

Offering vegetables to children at breakfast time in nursery and kindergarten settings: the Veggie Brek feasibility and acceptability cluster randomised controlled trial.

BACKGROUND: In many Westernised countries, children do not consume a sufficient amount of vegetables for optimal health and development. Child-feeding guidelines have been produced to address this, but often only promote offering vegetables at midday/evening meals and snack times. With guidance having limited success in increasing children's vegetable intake at a population level, novel approaches to address this must be developed. Offering vegetables to children at breakfast time in nursery/kindergarten settings has the potential to increase children's overall daily vegetable consumption as children typically attend nursery/kindergarten and many routinely eat breakfast there. However, the feasibility and acceptability of this intervention (Veggie Brek) to children and nursery staff has not been investigated. METHODS: A feasibility and acceptability cluster randomised controlled trial (RCT) was undertaken in eight UK nurseries. All nurseries engaged in one-week baseline and follow-up phases before and after an intervention/control period. Staff in intervention nurseries offered three raw carrot batons and three cucumber sticks alongside children's main breakfast food each day for three weeks. Control nurseries offered children their usual breakfast. Feasibility was assessed by recruitment data and nursery staff's ability to follow the trial protocol. Acceptability was assessed by children's willingness to eat the vegetables at breakfast time. All primary outcomes were assessed against traffic-light progression criteria. Staff preference for collecting data via photographs versus using paper was also assessed. Further views about the intervention were obtained through semi-structured interviews with nursery staff. RESULTS: The recruitment of parents/caregivers willing to provide consent for eligible children was acceptable at 67.8% (within the amber stop-go criterion) with 351 children taking part across eight nurseries. Both the feasibility and acceptability of the intervention to nursery staff and the willingness of children to consume the vegetables met the green stop-go criteria, with children eating some part of the vegetables in 62.4% (745/1194) of instances where vegetables were offered. Additionally, staff preferred reporting data using paper compared to taking photographs. CONCLUSIONS: Offering vegetables to children at breakfast time in nursery/kindergarten settings is feasible and acceptable to children and nursery staff. A full intervention evaluation should be explored via a definitive RCT. TRIAL REGISTRATION: NCT05217550.

A comparison of meal-related appetite, food reward and eating behaviour traits in people with and without spinal cord injury.

Persons with a spinal cord injury (SCI) are at a heightened risk of obesity. However, little is known about the effect of SCI on factors that influence energy intake. This study compared measures of food reward, eating behaviour traits, and appetite perceptions between adults with and without SCI. Twenty wheelchair dependent persons with chronic (>1 year) SCI (C1-T12) and twenty non-SCI individuals matched for BMI, age and sex participated. Following a familiarisation visit, participants consumed a breakfast meal, normalised for resting metabolic rate (RMR), and provided subjective appetite perceptions every 30 min for 4 h. Subsequently, energy intake was determined via an ad libitum lunch meal. Explicit liking, explicit wanting, implicit wanting and relative preference were assessed in a hungry and fed state via the Leeds Food Preference Questionnaire prior to and following the lunch meal. Eating behaviour traits were assessed via the Adult Eating Behaviour Questionnaire, Control of Eating Questionnaire, Reasons Individuals Stop Eating Questionnaire, and Three-Factor Eating Questionnaire Revised 18-item version. Sweet appeal bias was greater for explicit liking, explicit wanting, and relative preference in the group with SCI compared to the non-SCI group (p ≤ 0.024). The group with SCI also reported higher levels of cognitive restraint and satiety responsiveness (p ≤ 0.029). No group differences in postprandial appetite perceptions (p ≥ 0.690) or energy intake relative to RMR were seen (p = 0.358). However, the group with SCI demonstrated a trend toward a lower absolute energy intake (p = 0.063). In conclusion, food reward for sweet foods was greater in the group with SCI. Further, our findings suggest that acute appetite perceptions, including satiety profiles, are not different between persons with and without SCI.

Would offering vegetables to children for breakfast increase their total daily vegetable intake?

The consumption of vegetables is vitally important for children's health and development. However, in many Westernised countries, most children do not eat sufficient quantities of vegetables and consume many energy-dense and high-sugar foods; a health behaviour associated with the onset of non-communicable diseases. To address this important public health concern, it is necessary to think 'outside the box' and consider innovative and pragmatic ways to increase children's daily vegetable intake. In many countries, caregivers implementing best-practice child feeding methods typically offer children vegetables at lunch, dinner and for snacks. It is unusual for children to be routinely offered vegetables for breakfast, yet there is no nutritional, physiological or medical reason why vegetables should not be eaten at breakfast. Indeed, in some countries, children frequently consume vegetables for breakfast. Increasing children's exposure to vegetables at breakfast from an early age would allow for the development of a positive association between eating vegetables and breakfast, thus providing another opportunity in the day where vegetables might be regularly consumed by children. In this paper, we propose a rationale for why vegetables should be routinely offered to young children at breakfast time in countries where this may not be the norm. Future research assessing the feasibility and acceptability of such a public health intervention would provide health policy agencies with evidence about a potentially effective and easily implementable approach for increasing children's vegetable intake, thus improving their overall nutritional status, as well as their heath and development.

Barriers and facilitators for the safe handling of antineoplastic drugs.

INTRODUCTION: Antineoplastic drugs are widely used in the treatment of cancer. However, some are known carcinogens and reproductive toxins, and incidental low-level exposure to workers is a health concern. CAREX Canada estimated that approximately 75,000 Canadians are exposed to antineoplastic drugs in workplace settings. While policies and guidelines on safe handling of antineoplastic drugs are available, evidence suggests that compliance is low. In this paper, we identify barriers and facilitators for safe handling of antineoplastic drugs in workplace settings. METHODS: We utilized a unique method to study public policy which involved compiling policy levers, developing a logic model, conducting a literature review, and contextualizing data through a deliberative process with stakeholders to explore in-depth contextual factors and experiences for the safe handling of antineoplastic drugs. RESULTS: The most common barriers identified in the literature were: poor training (46%), poor safety culture (41%), and inconsistent policies (36%). The most common facilitators were: adequate safety training (41%), leadership support (23%), and consistent policies (21%). Several of these factors are intertwined and while this means one barrier can cause other barriers, it also allows healthcare employers to mitigate these barriers by implementing small but meaningful changes in the workplace. CONCLUSION: The combination of barriers and facilitators identified in our review highlight the importance of creating work environments where safety is a priority for the safe handling of antineoplastic drugs. The results of this study will assist policy makers and managers in identifying gaps and enhancing strategies that reduce occupational exposure to antineoplastic drugs.

Why are babies in Canada getting smaller?

INTRODUCTION: Recent evidence from the United States and Canada suggests an unexplained increase in small-for-gestational-age (SGA) births (<10th percentile). This study aimed to identify reasons for the recent increase in SGA births in Canada. DATA AND METHODS: Using Canada's Vital Statistics - Birth Database, the study population included all singleton live births, 2000 to 2016, inclusive. Temporal changes in birth weight (grams), birth weight for gestational age z-scores, and SGA births were examined. Multivariable logistic regression was used to determine if the ncreased risk of an SGA birth over time was eliminated or attenuated by adjusting for selected individual and sociodemographic factors that have previously been associated with SGA births. RESULTS: There were 5,941,820 singleton live births in Canada between 2000 and 2016. Mean birth weight for all births decreased from 3,442 grams in 2000, to 3,367 grams in 2016, while SGA birth increased from 7.2% in 2000 to 8.0% in 2016. The multivariable model showed higher odds of SGA birth among births to parents born outside of Canada, unmarried women, older women, nulliparous women and women residing in low income neighborhoods. After adjusting for sociodemographic factors, the crude 12% increase in odds of SGA birth in 2016 compared to 2000 (95% Confidence Interval (CI): [10 to 14%]) was attenuated, ut not eliminated (adjusted odds ratio for calendar time 1.08 (95% CI: [1.06, 1.10])). INTERPRETATION: This study identified a decrease in fetal size in Canada between 2000 and 2016. The rise in SGA births in Canada was explained only partly as a result of concurrent changes in the demography of childbirth.

Breast cancer risk by occupation and industry in women and men: Results from the Occupational Disease Surveillance System (ODSS).

BACKGROUND: The recently established Occupational Disease Surveillance System (ODSS) was used to examine breast cancer risk in women and men by occupation and industry. METHODS: Ontario workers in the ODSS cohort (1983-2016) were followed up for breast cancer diagnosis through the Ontario Cancer Registry. Cox-proportional hazard models were used to calculate age-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: A total of 17 865 and 492 cases were identified in working women (W) and men (M), respectively. Elevated risks were observed in management (W: HR = 1.54, 95% CI = 1.40-1.70; M: HR = 2.79, 95% CI = 1.44-5.39), administrative/clerical (W: HR = 1.16, 95% CI = 1.11-1.21; M: HR = 1.45, 95% CI = 1.06-1.99), and teaching (W: HR = 1.54, 95% CI = 1.44-1.63; M: HR = 3.00, 95% CI = 1.49-6.03). Other elevated risks were observed in nursing/health, social sciences, and janitor/cleaning services for both genders. CONCLUSIONS: Common occupational associations in both genders warrant investigation into job-related risk factors, such as sedentary behavior, shift work, ionizing radiation, and chemical exposures.

The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure.

OBJECTIVES: To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. METHODS: We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. RESULTS: There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. CONCLUSIONS: The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.

A systematic literature review of the effectiveness of occupational health and safety regulatory enforcement.

BACKGROUND: We aimed to determine the strength of evidence on the effectiveness of legislative and regulatory policy levers in creating incentives for organizations to improve occupational health and safety processes and outcomes. METHODS: A systematic review was undertaken to assess the strength of evidence on the effectiveness of specific policy levers using a "best-evidence" synthesis approach. RESULTS: A structured literature search identified 11,947 citations from 13 peer-reviewed literature databases. Forty-three studies were retained for synthesis. Strong evidence was identified for three out of nine clusters. CONCLUSIONS: There is strong evidence that several OHS policy levers are effective in terms of reducing injuries and/or increasing compliance with legislation. This study adds to the evidence on OHS regulatory effectiveness from an earlier review. In addition to new evidence supporting previous study findings, it included new categories of evidence-compliance as an outcome, nature of enforcement, awareness campaigns, and smoke-free workplace legislation. Am. J. Ind. Med. 59:919-933, 2016. © 2016 Wiley Periodicals, Inc.

An Assessment of the Imaging Performance of Hand-Held Ultrasound Scanners Using the Edinburgh Pipe Phantom.

OBJECTIVE: Although hand-held ultrasound devices (HHUSDs) are currently used for a diverse range of diagnostic and interventional applications the imaging performance of such scanners is rarely considered. The aim of this study was to assess the imaging performance of a wide-range of HHUSDs and compare their imaging performance to cart-based systems utilized for the same clinical applications. METHODS: The grayscale imaging performances of 19 HHUSDs from eight different manufacturers, manufactured between 2016 and 2021, were measured using a figure-of-merit known as the resolution integral. The imaging performance of the HHUSDs were compared to 142 cart-based ultrasound scanners. RESULTS: The HHUSD with the overall highest resolution integral (66) was a Butterfly (Burlington, MA, USA) wired phased array for small parts applications, followed by a Philips (Bothell, WA, USA) Lumify wired curvilinear transducer (57) for abdominal applications, a Butterfly wired phased array (56) for abdominal applications, a GE (Freiburg, Baden-Wurttemberg, Germany) VScan Air wireless linear array (56) for small parts applications, and a Healcerion (Seoul, Korea) Sonon 300L wireless linear array (56) for small parts applications. A GE VScan Extend wired phased array had the highest resolution integral (44) for cardiac applications. CONCLUSIONS: The Butterfly phased array had the highest resolution integral of all the 19 HHUSDs, although this value is still less than the majority of cart-based cardiac and abdominal ultrasound scanners manufactured from 2010 to 2017. Clinical users of HHUSDs should be mindful of the limitations in imaging performance of hand-held ultrasound devices.

COVID-19 and coping: Absence of previous mental health issues as a potential risk factor for poor wellbeing in females.

COVID-19 has caused unprecedented disruption to everyday life. Unsurprisingly, this has resulted in increased prevalence of poor mental wellbeing. While previous mental health issues have been consistently flagged as a risk factor, the absence of these may also leave individuals vulnerable due to a lack of psychological coping strategies. This study explored the change in symptoms of anxiety, depression, and trauma in 167 females who provided data at four timepoints over the course of the first year of the pandemic. There was a significant effect of time on the extent of the change in depression but, for all wellbeing measures, those with current or previous mental health issues experienced a similar magnitude of change as those with no previous issues. This suggests that low-risk individuals may be faring worse, relatively. Ensuring that this group is not overlooked will be imperative in protecting and re-building the wellbeing of the nation.

Sex differences in left-ventricular strain in a murine model of coxsackievirus B3 myocarditis.

Myocarditis is typically caused by viral infections, but most cases are thought to be subclinical. Echocardiography is often used for initial assessment of myocarditis patients but is poor at detecting subtle changes in cardiac dysfunction. Cardiac strain, such as global longitudinal strain (GLS) and global circumferential strain (GCS), represents an increasingly used set of measurements which can detect these subtle changes. Using a murine model of coxsackievirus B3 myocarditis, we characterized functional changes in the heart using echocardiography during myocarditis and by sex. We found that 2D GLS, 4D mode, and 4D strains detected a significant reduction in ejection fraction and GLS during myocarditis compared to baseline and in males compared to females. Furthermore, worse GLS correlated to increased levels of CD45+, CD11b+, and CD3+ immune cells. Our findings closely resemble published reports of GLS in patients with myocarditis indicating the usefulness of this animal model for translational studies of myocarditis.

Caenorhabditis elegans UCP4 protein controls complex II-mediated oxidative phosphorylation through succinate transport.

The novel uncoupling proteins (UCP2-5) are implicated in the mitochondrial control of oxidant production, insulin signaling, and aging. Attempts to understand their functions have been complicated by overlapping expression patterns in most organisms. Caenorhabditis elegans nematodes are unique because they express only one UCP ortholog, ceUCP4 (ucp4). Here, we performed detailed metabolic analyzes in genetically modified nematodes to define the function of the ceUCP4. The knock-out mutant ucp4 (ok195) exhibited sharply decreased mitochondrial succinate-driven (complex II) respiration. However, respiratory coupling and electron transport chain function were normal in ucp4 mitochondria. Surprisingly, isolated ucp4 mitochondria showed markedly decreased succinate uptake. Similarly, ceUCP4 inhibition blocked succinate respiration and import in wild type mitochondria. Genetic and pharmacologic inhibition of complex I function was selectively lethal to ucp4 worms, arguing that ceUCP4-regulated succinate transport is required for optimal complex II function in vivo. Additionally, ceUCP4 deficiency prolonged lifespan in the short-lived mev1 mutant that exhibits complex II-generated oxidant production. These results identify a novel function for ceUCP4 in the regulation of complex II-based metabolism through an unexpected mechanism involving succinate transport.

A Realist Review of Violence Prevention Education in Healthcare.

Violence from patients and visitors towards healthcare workers is an international concern affecting the safety and health of workers, quality of care, and healthcare system sustainability. Although the predominant intervention has been violence prevention (VP) education for healthcare workers, evaluating its effectiveness is challenging due to underreporting of violence and the inherent complexity of both violence and the health care environment. This review utilized a theory-driven, realist approach to synthesize and analyze a wide range of academic and grey literature to identify explanations of how and why VP education makes a difference in preventing violence and associated physical and psychological injury to workers. The review confirmed the importance of positioning VP education as part of a VP strategy, and consideration of the contexts that influence successful application of VP knowledge and skills. Synthesis and analysis of patterns of evidence across 64 documents resulted in 11 realist explanations of VP education effectiveness. Examples include education specific to clinical settings, unit-level modeling and mentoring support, and support of peers and supervisors during violent incidents. This review informs practical program and policy decisions to enhance VP education effectiveness in healthcare settings.

Planned Aerobic Exercise Increases Energy Intake at the Preceding Meal.

PURPOSE: Effects of exercise on subsequent energy intake are well documented, but whether preexercise energy intake is affected by future planned exercise is unknown. This study investigated the effect of planned late-afternoon exercise on appetite and energy intake before (breakfast and lunch) and after (evening meal/snacks) exercise. METHODS: Twenty healthy, active participants (10 male; age, 23 ± 5 yr; body mass index 23.7 ± 3.2 kg·m; V˙O2peak, 44.1 ± 5.4 mL·kg··min) completed randomized, counterbalanced exercise (EX) and resting (REST) trials. After trial notification, participants were provided ad libitum breakfast (0800 h) and lunch (1200 h) in the laboratory, before completing 1-h exercise (30-min cycling, 30-min running) at 75%-80% maximal HR (EX, 2661 ± 783 kJ) or 1-h supine rest (REST, 310 ± 58 kJ) 3 h after lunch. Participants were provided a food pack (pasta meal/snacks) for consumption after exercise (outside laboratory). Appetite was measured regularly, and meal and 24-h energy intake were quantified. RESULTS: Ad libitum energy intake was greater during EX at lunch (EX, 3450 ± 1049 kJ; REST, 3103 ± 927 kJ; P = 0.004), but similar between trials at breakfast (EX, 2656 ± 1291 kJ; REST, 2484 ± 1156 kJ; P = 0.648) and dinner (EX, 6249 ± 2216 kJ; REST, 6240 ± 2585 kJ; P = 0.784). Total 24-h energy intake was similar between trials (P = 0.388), meaning that relative energy intake (24-h energy intake minus EX/REST energy expenditure) was reduced during EX (EX, 9694 ± 3313 kJ; REST, 11,517 ± 4023 kJ; P = 0.004). CONCLUSION: Energy intake seems to be increased in anticipation of, rather than in response to, aerobic exercise, but the increase was insufficient to compensate for energy expended during exercise, meaning that aerobic exercise reduced energy balance relative to rest.

Men and Women's Occupational Activities and the Risk of Developing Osteoarthritis of the Knee, Hip, or Hands: A Systematic Review and Recommendations for Future Research.

OBJECTIVE: To systematically review the evidence for an increased risk of osteoarthritis in the hip, knee, hand, wrist, finger, ankle, foot, shoulder, neck, and spine related to diverse occupational activities of men and women and to examine dose-response information related to the frequency, intensity, and duration of work exposures and the risk of osteoarthritis (OA). METHODS: Established guidelines for systematic reviews in occupational health and safety studies were followed. MEDLINE, Embase, CINAHL, and Cochrane Library were searched from inception to December 2017. Studies were reviewed for relevance, quality was appraised, and data were extracted and synthesized. RESULTS: Sixty-nine studies from 23 countries yielded strong and moderate evidence for lifting, cumulative physical loads, full-body vibration, and kneeling/squatting/bending as increasing the risks of developing OA in men and women. Strong and moderate evidence existed for no increased risk of OA related to sitting, standing, and walking (hip and knee OA), lifting and carrying (knee OA), climbing ladders (knee OA), driving (knee OA), and highly repetitive tasks (hand OA). Variability in dose-response data resulted in an inability to synthesize these data. CONCLUSION: Evidence points to the potential for OA occupational recommendations and practice considerations to be developed for women and men. However, research attention is needed to overcome deficits in the measurement and recall of specific work activities so that recommendations and practice considerations can provide the specificity needed to be adopted in workplaces.

FPGA design and implementation for EIT data acquisition.

OXBACT-5 was designed to meet the challenges involved in working in the intensive care hospital environment focussed particularly on thoracic imaging of patients with respiratory distress and chronic heart failure (CHF). The FPGA-based wireless LAN linked multi-channel EIT data acquisition system (DAS) providing 16 programmable excitation current channels and 64 voltage measurement channels is presented. It contains function modules of a PCI bus interface, direct digital synthesizers, dual-port memory blocks, digital demodulation and all the command and control logic in the FPGA. The whole EIT data acquisition system is fully programmable and reconfigurable from the host PC. The excitation frequency, excitation patterns, the measuring sequence and the gain of each measurement channel can be set from the host PC before each measurement. The demodulation is implemented in the FPGA chip to reduce the data rate between the DAS and the host PC. In addition, measurement process management is achieved in this FPGA chip. Complemented by analogue devices such as ADCs, DACs, analogue buffers and analogue multiplexers, the new FPGA-based EIT DAS system is implemented in a very compact way for bedside use in intensive care units of hospitals. It is intended for applications such as continuous respiration monitoring with data collection at 25 frames per second. Image reconstruction times depend on the choice of 2D or 3D imaging algorithms and the available processing power.

Systematic review of the prevention incentives of insurance and regulatory mechanisms for occupational health and safety.

OBJECTIVES: The objective of this study was to determine the strength of evidence on the effectiveness of two policy levers-the experience rating of workers' compensation insurance and the enforcement of occupational health and safety regulation-in creating incentives for firms to focus on health and safety issues. METHODS: An extensive systematic literature review was undertaken in an effort to capture both published and grey literature studies on the topic. Studies that met specific subject-matter and methods criteria underwent a quality assessment. A qualitative approach to evidence synthesis, known as "best-evidence" synthesis, was used. This method ranks the strength of evidence on a particular topic on the basis of the number, quality, and consistency of studies on the topic. RESULTS: There was moderate evidence that the degree of experience rating reduces injuries, limited to mixed evidence that inspections offer general and specific deterrence and that citations and penalties aid general deterrence, and strong evidence that actual citations and penalties reduce injuries. CONCLUSIONS: Although experience rating is a key policy lever of those providing workers' compensation insurance, there is much to be learned about its merits. Few studies have concerned the topic, and most have used crude proxy measures or exploited natural experiments. There have been many more studies on the merits of regulation enforcement, even though here too measures were often crude. Nonetheless, this synthesis indicates that general deterrence is less effective in reducing injury incidence and severity, whereas specific deterrence with regard to citations and penalties does indeed have an impact.