[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.

Eye Health, COVID-19, and the Occupational Health Professional: Round Table.

BACKGROUND: Eye health has garnered increased attention since the COVID-19 pandemic. This Round Table explored the impact mask wearing, delays in eye examinations, and increased screen time have on vision and ultimately the worker. METHODS: Leading experts in the areas of occupational health, risk management, eye health, and communication were identified and invited to participate in a Round Table discussion. Questions posed to experts were based on literature that addressed eye health, such as mask wearing, communication and managing expectations when accessing professional eye health appointments, and increased screen time. FINDINGS: Experts agreed that eye health considerations must be in place. These considerations should address not only clinical care of the patient but ways to protect workers from occupational injury associated with the eye. CONCLUSION/APPLICATION TO PRACTICE: The occupational health professional is a key resource for assessment and training that pertains to eye health.

Detainee and layperson's expectations and preferences regarding police interview rooms.

Emerging research on how suspects perceive the physical environment during investigative interviews yields contrasting findings. While previous studies have suggested that a room made to be physically comfortable may be optimal for interviewing suspects, another study found it can instead lead to higher suspicion of the investigator's intentions. The current study examined current detainees' and general population participants' beliefs about a room that resembled a "typical" interview room, and one decorated to be warm, inviting, and comfortable. Participants also provided descriptive information about their perceptions of police interview environments (e.g., preferences, expectations). We hypothesized that the decorated room would elicit higher ratings of suspicion and wariness compared to the "typical" room. Our findings showed that, overall, participants expected to be interviewed in the "typical" room but preferred the decorated one. Contrary to our expectations, they rated the "typical" room higher on feelings of suspicion than the decorated room. The decorated room also corresponded with what participants reported to be an environment that promotes disclosure. These results bode well for conducting investigative interviews in comfortable environments.

Teachers' Perspective on Strategies to Reduce Sedentary Behavior in Educational Institutions.

Standing desks and physical activity breaks can counteract the negative consequences of sedentarism at school. However, the implementation of these strategies should not restrict the pedagogical process. The aim of this study was to assess teachers' perspectives on strategies to reduce sedentary behavior (SB) of students in the classroom. An online survey was conducted, and the answers were analyzed using descriptive statistics and frequency distribution. The relationships between the variables were assessed using Spearman's coefficient and a chi-square test. Most teachers believed that a student-furniture mismatch was present. The most common reasons given for not using standing desks were concerns about desks being uncommon and their potential to disrupt the class. However, the majority of the teachers believed it feasible to perform physical activity (PA) breaks during classes. Further intervention studies are needed to determine for which courses the use of standing desks are feasible, for what time periods standing desks should be used, and the appropriate number and layout of standing desks in classrooms.

Developing a Multi-Criteria Decision Making approach to compare types of classroom furniture considering mismatches for anthropometric measures of university students.

The mismatch between students' anthropometric measures and school furniture dimensions have been investigated in many countries. In Iran, collegians spend at least a quarter of the day hours at university in the sitting position, so it is essential to evaluate furniture mismatch among university students. In Iranian universities, the use of chairs with an attached table is widespread, while the study of mismatches in these chairs among the collegian community is rare. This study was aimed to compare and rank different classroom furniture types based on the mismatch between collegians' anthropometric measures and the dimensions of classroom furniture among Industrial Engineering students by developing a Multi-Criteria Decision Making approach in an integrated Methodology. The sample consisted of 111 participants (71 males, 40 females). Ten anthropometric measures were gathered, together with eight furniture dimensions for four types of chairs. Mismatch analyses were carried out using mismatch equations, and the Simple Additive Weighting method was used as a base method to solve the decision-making problem. The results indicated that Underneath Desk Height and Seat to Desk Clearance showed the highest levels of the match, while Seat Width presents the highest levels of low mismatch. According to the results, Type 1 and Type 3 were the best current classroom furniture. The Sensitivity Analysis was performed in two ways: changing the weights of criteria in nine scenarios and comparing the results with five other MCDM methods. The proposed MCDM approach can be used widely in furniture procurement processes and educational environments.

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.

The effects of the seat cushion contour and the sitting posture on surface pressure distribution and comfort during seated work.

OBJECTIVES: The purpose of this paper is to investigate the effects of the seat cushion contour and the sitting posture on the seat pan interface pressure distribution and subjective comfort perception. MATERIAL AND METHODS: Overall, 16 volunteers typed a text passage on a laptop while seated, by assuming 3 kinds of common sitting postures (forward, relaxed and upright) in 4 seat cushion configurations: chair only, and chair with 1 of 3 supplementary cushions. Pressure data and cushion comfort ratings were collected in the experiment. RESULTS: It was found that the sitting posture and the seat cushion contour had different impacts on surface pressure. The seat cushion contour had an impact on pressure parameters and pressure distribution on the seat pan, while the sitting posture affected the location of peak pressure on the seat pan. The correlation analysis revealed that the subjective comfort rating was significantly correlated with average pressure (AP) and mean peak pressure (MPP). CONCLUSIONS: The conclusion was that the cushion contour had a greater effect on seat pan interface pressure parameters than the sitting posture. Notably, AP and MPP can be indicators for assessing seat cushion comfort in a short-term perspective. Int J Occup Med Environ Health. 2020;33(5):675-89.

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.

A Conceptual Visibility Framework for Linking Spatial Metrics With Experience and Organizational Outcomes.

Visibility enables or prohibits healthcare professionals' ability to monitor, control, or manage situations in healthcare settings. Visibility has a significant impact on patient safety, including patient fall rates and mortality rates, and on the performance of healthcare professionals, including situational awareness and communication. This article provides a conceptual visibility framework synthesizing visibility analysis models, tools, and metrics. The framework uses four dimensions that capture the experiential phenomena of users, such as visual relationships between specific sets of users/targets, how the orientation of the seeing entity changes visibility patterns, and the unequal visibility levels of seeing and being seen. The framework particularly focuses on how the layout and the resulting patterns of visibility reflect and influence the user experience and organizational functions. By illustrating the similarities and differences of various models in the framework according to the dimensions, this article describes how various visibility analysis models, tools, and metrics can be applied to design and research.

The Ipswich Microbreak Technique to alleviate neck and shoulder discomfort during microscopic procedures.

Neck and shoulder disorders are a considerable health problem amongst frequent microscope users. We aimed to investigate the neck and shoulder discomfort experienced during prolonged microscopic activity and to assess the benefits of minibreaks. A prospective crossover study was performed on 17 healthy volunteers sitting still while looking down a bench with and without the Ipswich Microbreak Technique (IMT). We used a subjective measure of time to fatigue and pain in the neck and shoulder regions as well as objective readings from a surface electromyogram (sEMG). The IMT delayed the sensation of pain in the neck and shoulder region while reducing the overall sEMG muscle activation. In conclusion, IMT is a useful strategy in reducing and delaying the pain in neck and shoulder from prolonged working under the microscope. This technique can be incorporated in other activities that involve a sustained stationary position.

Determining optimum seat depth using comfort and discomfort assessments.

The aim of this study was to determine optimum seat depth using subjective assessments. Comfort and discomfort evaluation, as an ergonomic subjective method, was used to find the optimum seat depth. A total of 36 university students rated the comfort and discomfort of six different seat depths (including 32.0, 37.0, 42.0, 47.0 and 52.0 cm which covered the buttock-popliteal length [BPL] range as well as 40.2 cm representing the 5th percentile of the BPL) during a 90-min period using a chair evaluation checklist. The results showed that a seat depth of 40.2 cm (equivalent to the 5th percentile of the BPL) was more comfortable and caused less discomfort ratings after 90 min compared to other experimental seat depths. The findings suggest that an appropriate seat depth for the studied population can be recommended based on the 5th percentile of the BPL as an anthropometric criterion.

Estructura de las unidades de cuidados intensivos de anestesia: recomendaciones de la Sección de Cuidados Intensivos de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR) / Structure of the anesthesia intensive care units: recommendations of the Intensive Care Section of the Spanish Society of Anaesthesiology

ANTECEDENTES Y OBJETIVO: Los objetivos de la Sección de Cuidados Intensivos de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SCI-SEDAR) con el presente trabajo son: establecer nuevas recomendaciones adaptando los estándares publicados por el Ministerio de Sanidad y Política Social, y alineadas con las principales guías internacionales, y desarrollar una herramienta de mejora de la calidad y la eficiencia. MATERIALES Y MÉTODO: A lo largo de 2018, 3 miembros de la SCI-SEDAR definieron la metodología, desarrollaron las recomendaciones y seleccionaron al panel de expertos. Debido a la limitada evidencia de buena parte de las recomendaciones y a la importante variabilidad estructural de las unidades de cuidados intensivos de anestesia actuales, se optó por un abordaje Delphi modificado para determinar el grado de consenso. RESULTADOS: Un total de 24 expertos de 21 instituciones constituyeron el grupo de expertos del presente trabajo. Se establecieron 175 recomendaciones sobre 8 apartados, incluyendo 129 con consenso fuerte y 46 con consenso débil. CONCLUSIONES: La SCI-SEDAR estableció las recomendaciones estructurales de las unidades de cuidados intensivos de anestesia que deberán guiar la renovación o la creación de nuevas unidades

BACKGROUND AND OBJECTIVE: In this article, the Intensive Care Section of the Spanish Society of Anesthesiology (SCI-SEDAR) establishes new recommendations based on the standards published by the Ministry of Health, Consumer Affairs and Social Welfare and aligned with the principle international guidelines, and develops a tool to improve quality and efficiency. MATERIALS AND METHOD: Over a 12-month period (2018), 3 members of the SCI-SEDAR defined the methodology, developed the recommendations and selected the panel of experts. Due to the limited evidence available for many of the recommendations and the significant structural differences between existing anesthesia intensive care units, we chose a modified Delphi approach to determine the degree of consensus. RESULTS: The panel consisted of 24 experts from 21 institutions. The group put forward 175 recommendations on 8 sections, including 129 with strong consensus and 46 with weak consensus. CONCLUSIONS: The SCI-SEDAR has established a series of structural recommendations that should be used when renovating or creating new anesthesia intensive care units

Structure of the Anesthesia Intensive Care Units: Recommendations of the Intensive Care Section of the Spanish Society of Anaesthesiology. / Estructura de las unidades de cuidados intensivos de anestesia: recomendaciones de la Sección de Cuidados Intensivos de la Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor (SEDAR).

BACKGROUND AND OBJECTIVE: In this article, the Intensive Care Section of the Spanish Society of Anesthesiology (SCI-SEDAR) establishes new recommendations based on the standards published by the Ministry of Health, Consumer Affairs and Social Welfare and aligned with the principle international guidelines, and develops a tool to improve quality and efficiency. MATERIALS AND METHOD: Over a 12-month period (2018), 3 members of the SCI-SEDAR defined the methodology, developed the recommendations and selected the panel of experts. Due to the limited evidence available for many of the recommendations and the significant structural differences between existing anesthesia intensive care units, we chose a modified Delphi approach to determine the degree of consensus. RESULTS: The panel consisted of 24 experts from 21 institutions. The group put forward 175 recommendations on 8 sections, including 129 with strong consensus and 46 with weak consensus. CONCLUSIONS: The SCI-SEDAR has established a series of structural recommendations that should be used when renovating or creating new anesthesia intensive care units.

Analysis of neck and shoulder postures, and muscle activities relative to perceived pain during laptop computer use at a low-height table, sofa and bed.

BACKGROUND: Laptop computers are used in various places and situations. The number of laptop users experiencing musculoskeletal disorders (MSDs) has increased drastically due to, in part, inappropriate workstations. OBJECTIVE: To investigate the neck and shoulder postures, and muscle activity relative to perceived pain when using the laptop at a low-height table, sofa, and bed. METHODS: Twenty male participants aged 18-25 years were randomly assigned to perform laptop computer operation at 3 workstations for 10 minutes during which neck and shoulder angles, muscle activity, and pain were recorded by using an Electrogoniometer, Electromyography (EMG), and visual analog scale (VAS), respectively. RESULTS: Neck flexions when working at the sofa (18.6°±12.2°) and bed (17.2°±10.5°) were significantly (p < 0.05) greater than that at the low-height table (7.8°±6.5°). However, shoulder flexion when working at the low-height table (28.2°±13.0°) was significantly (p < 0.05) greater than that at the sofa (13.8°±8.6°) and bed (10.91°±7.8°). Working at the low-height table caused the shoulder flexor muscle activity to be significantly (p < 0.05) higher than working at the sofa and bed. Neck pain was reported during laptop computer use at the sofa and bed, and upper back pain when working at the low-height table. CONCLUSIONS: High neck flexion and pain were found while working at sofa and bed, whereas high muscle activity at shoulder and upper back pain were found while working at the low-height table.

A Grounded Theoretical Analysis of Room Elements Desired by Family Members and Visitors of Hospitalized Patients: Implications for Medical/Surgical Hospital Patient Room Design.

OBJECTIVE:: To identify family members' and visitors' needs with relation to the design of a hospital room. BACKGROUND:: There is a trend toward incorporating family zones in hospital patient rooms in order to improve patient satisfaction and encourage family caregivers to stay longer and overnight. METHOD:: A mixed-method study was employed. Interviews of patients and family caregivers were conducted to understand opportunities to improve hospital room designs based on recent experiences. Features intended to support short-term and overnight visitors were embedded in five full-scale simulated room design concepts. Small groups of family caregivers and patients toured two room design concepts and reacted real time to room features. A grounded theory approach was employed to identify emerging themes. RESULTS:: A theoretical design framework is developed for the needs of family members and visitors for a range of time periods. This framework is founded upon desires to help make the patient feel more comfortable. There are various levels of helping the patient feel more comfortable, including visiting, keeping company, providing support, providing assistance, and being a caregiver. Beyond this core need, family members and visitors must take care of their own needs in order to feel comfortable in the hospital room. Activities associated with these needs include sitting, relaxing, eating, working, tending to daily needs, and resting overnight. CONCLUSIONS:: Potential implications for architects, healthcare planners, and interior space designers are described. Design and renovation guidance for the hospital room environment in order to support the needs and expectations of families and visitors is provided.

Horseshoe, Cockpit, and Dragonfly: Nurse Movement in Headwall Patient Rooms.

An exploratory, qualitative study conducted on 6 units in 4 hospitals featured field observations of 20 experienced nurses during complete 12-hour day and night shifts, followed by semistructured participant interviews. All patient rooms featured conventional headwall-type life support systems in which the head of the bed is against the wall where multiple electrical, gas, and communication utilities are located. Critical care nurses displayed repetitive movement patterns around the patient and the bed. Movement patterns observed varied according to room size, availability of supplies, and positions of fixed and/or mobile equipment, along with types and locations of documentation computers.

Patients' perception of privacy and confidentiality in the emergency department of a busy obstetric unit.

BACKGROUND: Privacy and confidentiality are central components of patient care and are of particular importance in obstetrics and gynaecology, where clinical situations of a sensitive nature regularly occur. The layout of the emergency department (ED) in maternity units is often not conducive to maintaining privacy. METHOD: Our study aimed to discover if changing the environment could improve patients' experiences in the ED. We surveyed patients and asked specific questions about their perception of privacy in the ED. We then repeated the survey following renovations to the ED which involved replacing curtained patient areas with walled cubicles. RESULTS: There were 75 pre-renovation surveys and 82 post-renovation surveys completed. Before the renovations took place, only 21% (n = 16) found their privacy to be adequate during their visit to the ED. However this rose to 89% (n = 73) post-renovation. CONCLUSION: Our study showed that patients' perception of privacy and confidentiality significantly improved following refurbishment of the ED.

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.

The office changes leading to sit-to-stand ergonomics.

The office ergonomic design from the late 1980s to the present has undergone significant changes during the transition from typewriters to the various human computer interfaces that evolved to the present day. Designs to accommodate various sized monitors and pointing devices have posed a challenge for ergonomist and designers of office workstations. Recent research suggesting adverse health effects associated with sedentary work environments have put additional pressure to incorporate the option to stand while working. This article reviews the current available options and suggests approaches to workplace design to meet the desire for employees to vary their work environment and the concern by management for worker health.