Occupational Diseases of Professional Orchestra Musicians from Northern Portugal: A Descriptive Study.

BACKGROUND: Owing to repetitive movements and a very stressful and competitive lifestyle, musicians are a group that may be prone to suffer from occupational diseases. According to the literature, musicians are affected mainly by two types of occupational diseases: music performance anxiety (MPA) and playing-related musculoskeletal disorders (PRMDs). The aim of this study was to describe the prevalence of the most common complaints affecting musicians in the three professional orchestras from northern Portugal. METHODS: Professional orchestra musicians (n=112) from the three main professional orchestras from northern Portugal were individually interviewed about their physical and psychological complaints. RESULTS: Results indicated that 94% of musicians interviewed self-reported at least one working-related problem. PRMDs were the most common conditions, affecting 84.8% of musicians. The most affected areas were the shoulder and the cervical and lumbar regions. MPA was reported by 13.2% of musicians. CONCLUSION: The present work covers about 50% of all Portuguese professional orchestra musicians. It raises awareness of the importance of focusing on the high prevalence of professional diseases among musicians.

Musculoskeletal pain in musicians: does playing more than one instrument have more effect?

Objectives. Repeated instrumental practice represents a risk factor for the appearance of playing-related musculoskeletal disorders (PRMDs). This study aimed to compare the prevalence and characteristics of PRMDs based on location, pain characteristics and number of hours of instrumental practice, in musicians who play one or more musical instruments.Methods. An observational study was conducted with music university students in Spain using a questionnaire.Results: A total of 178 musicians (41%) played a second instrument. Musicians who played only one instrument had a slightly lower mean number of pain sites (M 3.25, SD 1.93; M 3.44, SD 2.27). On the contrary, pain intensity (M 2.72, SD 2.03; M 2.23, SD 1.78 points), pain interference on mood, quality of life and instrumental practice (M 3.04, SD 2.29; M 2.80, SD 2.24 points) as well as the number of hours devoted to instrumental practice (M 21.18, SD 10.47; M 20.03, SD 12.54 h/week) is slightly higher in musicians playing a single instrument.Conclusions. Pain intensity is the only variable of those analysed that presents statistically significant differences when comparing musicians who play a single instrument with those who play a second instrument, being higher in mono-instrumental musicians.

Effects of qigong on performance-related anxiety and physiological stress functions in transverse flute music schoolchildren: a feasibility study.

OBJECTIVE: Based on individual cases of treatment, we were interested in whether the effects of a special kind of qigong, the "White Ball" exercises, can be objectified by physically measurable parameters and psychological scores. METHODS: We performed a preliminary prospective controlled interventional study with the waiting list design. In the qigong group eight children were included. They received specific qigong lessons of the "White Ball" qigong over seven weeks, twice a week, for 30 min with a waiting list design and instructions to perform the same exercises at home daily. In the control group eight children were included in a waiting list design with no qigong instruction. Subjective perception of anxiety was measured by the Portuguese version of the Depression, Anxiety and Stress Scale adapted for children. In addition, salivary cortisol, heart rate variability, blood pressure, surface electromyography of the trapezius muscle and reaction time were measured at the beginning and the end of the study prior to the regular public auditions. RESULTS: In comparison to the changes in the control group, the qigong group scored significantly lower in heart rate. Otherwise the groups did not differ significantly; however, the effect size was large for salivary cortisol, surface electromyography of the trapezius muscle and blood pressure. There were relevant reductions of subjective perception of anxiety, salivary cortisol levels and heart rate. CONCLUSION: The heart rate of performing schoolchildren can be potentially reduced by "White Ball" exercises. Based on a sample of 8/8, positive tendencies were also observed for anxiety and blood pressure. The next steps of objectifying possible qigong effects are to increase the sample size, to study young people in other situations arousing anxiety, to develop an appropriate control intervention, to solve the problem of blinding and double blinding, to find additional parameters that may be influenced by the "White Ball" qigong, and to compare the qigong effects with other methods reducing anxiety such as more traditional biofeedback or systematic desensitization.

Playing-Related Musculoskeletal Disorders of Professional Orchestra Musicians from the North of Portugal: Comparing String and Wind Musicians.

INTRODUCTION: It is well known that musicians are a group prone to suffer from playing-related musculoskeletal disorders. Professional orchestra musicians play for several hours a week and have to fight against pain caused by their profession. The aim of this study was to explore and describe self-reported complaints among professional orchestra musicians and to compare its intensity and the prevalence between string and wind instruments. MATERIAL AND METHODS: Hundred and twelve professional orchestra musicians from the three main professional orchestras from the North of Portugal were individually interviewed about the prevalence and the intensity (measured by verbal numerical scale for pain) of their playing-related musculoskeletal disorders. RESULTS: About two third (62.5%) of the interviewed musicians presented playing-related musculoskeletal disorders during the time of the interview. Despite there are no significant statistic values between groups, results suggested that playing-related musculoskeletal disorders are more common in string players and more intense in wind players. DISCUSSION: Referring to the prevalence of playing-related musculoskeletal disorders, our data is in line with other studies from different countries. More than half of professional orchestra musicians in the North of Portugal are playing with a mild to moderate pain. CONCLUSION: Future studies focusing on working-related problems among professional orchestra musicians in Portugal would be useful to better describe the problem of occupational diseases among performing artist.

Introdução: A literatura estabelece claramente que os músicos são um grupo com elevado risco de desenvolvimento de lesões músculoesqueléticas relacionadas com o trabalho. Os músicos profissionais de orquestra trabalham semanalmente durante várias horas e deparam-se frequentemente com a dor como consequência da sua profissão. O presente estudo pretende descrever a prevalência e a severidade das lesões músculoesqueléticas relacionadas com o trabalho que afetam os músicos de orquestras profissionais do Norte de Portugal, comparando instrumentistas de cordas e de sopros. Material e Métodos: Cento e doze músicos das três orquestras profissionais do Norte de Portugal foram entrevistados individualmente de forma a determinar a prevalência e a intensidade da dor (medida pela escala verbal numérica de dor) das suas lesões músculoesqueléticas relacionadas com o trabalho. Resultados: Aproximadamente dois terços (62,5%) dos músicos entrevistados apresentaram lesões músculoesqueléticas relacionadas com o trabalho durante a entrevista. Apesar de não se verificarem diferenças estatisticamente significativas, os resultados obtidos sugerem que as lesões músculoesqueléticas relacionadas com o trabalho são mais frequentes nos instrumentistas de cordas e mais intensas nos instrumentistas de sopro. Discussão: Os resultados referentes à prevalência de lesões músculoesqueléticas relacionadas com o trabalho são similares a resultados de outros estudos realizados em diferentes países. Mais da metade dos músicos de orquestras profissional no Norte de Portugal apresentam diariamente dor leve a moderada. Conclusão: Verifica-se a necessidade de realização de investigações futuras com o objetivo de estudar com maior profundidade os problemas profissionais que afetam os músicos em Portugal.

Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: a randomized controlled trial.

BACKGROUND: Musicians are frequently affected by playing-related musculoskeletal disorders (PRMD). Common solutions used by Western medicine to treat musculoskeletal pain include rehabilitation programs and drugs, but their results are sometimes disappointing. OBJECTIVE: To study the effects of self-administered exercises based on Tuina techniques on the pain intensity caused by PRMD of professional orchestra musicians, using numeric visual scale (NVS). DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: We performed a prospective, controlled, single-blinded, randomized study with musicians suffering from PRMD. Participating musicians were randomly distributed into the experimental (n=39) and the control (n=30) groups. After an individual diagnostic assessment, specific Tuina self-administered exercises were developed and taught to the participants. Musicians were instructed to repeat the exercises every day for 3 weeks. MAIN OUTCOME MEASURES: Pain intensity was measured by NVS before the intervention and after 1, 3, 5, 10, 15 and 20 d of treatment. The procedure was the same for the control group, however the Tuina exercises were executed in points away from the commonly-used acupuncture points. RESULTS: In the treatment group, but not the control group, pain intensity was significantly reduced on days 1, 3, 5, 10, 15 and 20. CONCLUSION: The results obtained are consistent with the hypothesis that self-administered exercises based on Tuina techniques could help professional musicians controlling the pain caused by PRMD. Although our results are very promising, further studies are needed employing a larger sample size and double blinding designs.

Immediate effects of Tuina techniques on working-related musculoskeletal disorder of professional orchestra musicians.

BACKGROUND: Musicians are a prone group to suffer from working-related musculoskeletal disorder (WRMD). Conventional solutions to control musculoskeletal pain include pharmacological treatment and rehabilitation programs but their efficiency is sometimes disappointing. OBJECTIVE: The aim of this research is to study the immediate effects of Tuina techniques on WRMD of professional orchestra musicians from the north of Portugal. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: We performed a prospective, controlled, single-blinded, randomized study. Professional orchestra musicians with a diagnosis of WRMD were randomly distributed into the experimental group (n=39) and the control group (n=30). During an individual interview, Chinese diagnosis took place and treatment points were chosen. Real acupoints were treated by Tuina techniques into the experimental group and non-specific skin points were treated into the control group. Pain was measured by verbal numerical scale before and immediately after intervention. RESULTS: After one treatment session, pain was reduced in 91.8% of the cases for the experimental group and 7.9% for the control group. CONCLUSION: Although results showed that Tuina techniques are effectively reducing WRMD in professional orchestra musicians of the north of Portugal, further investigations with stronger measurements, double-blinding designs and bigger simple sizes are needed.

Qigong as a Traditional Vegetative Biofeedback Therapy: Long-Term Conditioning of Physiological Mind-Body Effects.

A contemporary understanding of Chinese Medicine (CM) regards CM diagnosis as a functional vegetative state that may be treated by vegetative reflex therapies such as acupuncture. Within this context, traditional mind-body exercises such as Qigong can be understood as an attempt to enhance physiological proprioception, by combining a special state of "awareness" with posture, movement, and breath control. We have formerly trained young auditing flutists in "White Ball" Qigong to minimize anxiety-induced cold hands and lower anxiety-induced heart rate. Functional changes occurred 2-5 min after training and were observed over the whole training program, allowing the children to control their symptoms. In our current work, we report that warm fingers and calm hearts could be induced by the children even without Qigong exercises. Thus, these positive changes once induced and "conditioned" vegetatively were stable after weeks of training. This may show the mechanism by which Qigong acts as a therapeutic measure in disease: positive vegetative pathways may be activated instead of dysfunctional functional patterns. The positive vegetative patterns then may be available in critical stressful situations. Qigong exercise programs may therefore be understood as an ancient vegetative biofeedback exercise inducing positive vegetative functions which are added to the individual reactive repertoire.

Avaliação da prevalência de dermatites de contato ocupacionais em profissionais de beleza atuantes em Goiânia, Goiás, Brasil

Objetivos ­ Avaliar a prevalência das dermatites de contato (DC) ocupacionais, destacando os principais tipos de cosméticos indutores, o conhecimento dos participantes sobre a doença, o seu diagnóstico e tratamento em uma amostra de 378 profissionais da beleza atuantes em Goiânia, Goiás. Métodos ­ Estudo transversal descritivo, prospectivo, com abordagem quantitativa. Resultados ­ Um total de 43,9% dos participantes deste estudo declararam apresentar DC após exposição a produtos cosméticos no trabalho. Cerca de 64,0% dos participantes desta pesquisa não demonstraram conhecimento satisfatório relacionado aos principais agentes causadores diretos das DC ocupacionais. As tinturas e descolorantes capilares, produtos para alisamentos capilares e produtos para maquilagem foram os cosméticos mais relacionados com o desenvolvimento das DC ocupacionais nestes profissionais. As regiões corporais dos profissionais mais afetadas pelas lesões das DC ocupacionais foram as mãos, o couro cabeludo e a face. A partir do diagnóstico da DC 25,8% dos profissionais tiveram que mudar de atividade laboral dentro do seu segmento de trabalho. Cerca de 28,8% dos profissionais apresentaram conhecimento insatisfatório sobre as principais medidas de prevenção das DC ocupacionais. Conclusão ­ A implementação ou aprimoramento de programas preventivos primários eficazes, pelos estabelecimentos e instituições formadoras destes profissionais é primordial para a redução da prevalência das dermatites ocupacionais. O conhecimento e a conscientização sobre fatores de risco individuais pela categoria é extremamente importante, especialmente nos aprendizes, que constituem um grupo-alvo para a execução de medidas de prevenção primária

Objectives ­ To evaluate the prevalence of occupational contact dermatites (CD), highlighting the main types of inductive cosmetics, the participants' knowledge about the disease, its diagnosis and treatment in a sample of 378 beauty professionals working in Goiania, Goias. Methods ­ Descriptive, prospective cross-sectional study with a quantitative approach. Results ­ A total of 43.9% of the participants in this study reported having CD after exposure to cosmetic products at work. About 64.0% of the participants of this research did not demonstrate satisfactory knowledge related to the main direct causative agents of occupational CD. Hairdye and bleaching agents for hair, hair straighteners and make-up products were the cosmetics most associated with occupational CD in these professionals. The body regions of the professionals most affected by occupational DC injuries were the hands, scalp and face. From the diagnosis of CD 25.8% of the professionals had to change their work activity within their work segment. About 28.8% of the professionals presented unsatisfactory knowledge about the main measures of prevention of occupational DC. Conclusion ­ The implementation or improvement of effective primary prevention programs by the institutions and training institutions of these professionals is necessary to reduce the prevalence of occupational dermatitis. Knowledge and awareness of individual risk factors by category is extremely important, especially for apprentices, who are a target group for the implementation of primary prevention measures

Perspectiva dos condutores/maqueiros diante dos incidentes ocorridos no transporte de pacientes / Perspective of handlers/stretchers-bearers through the incidents occurred in transportation of patients

Objetivo: analisar os incidentes ocorridos durante o transporte intra-hospitalar dos pacientes na perspectiva dos condutores/maqueiros. Método: estudo quantitativo, exploratório, descritivo, realizado com 10 maqueiros de um hospital universitário. A coleta de dados foi realizada por meio de um formulário estruturado, com análise descritiva dos dados. Resultados: 60% dos trabalhadores relataram participação em cursos de capacitação; dentre os incidentes ocorridos durante o transporte intra-hospitalar, identificou-se a desconexão de O2 (oxigênio), de sonda, de equipo de soro, quebra de maca, paciente com parada cardíaca, crise de vômitos e quedas. Conclusão: os incidentes relatados pelos maqueiros, advindos do transporte do paciente, configuram-se em uma inconformidade com as diretrizes, pois colocam os trabalhadores em situação de vulnerabilidade a estes incidentes. (AU)

Diagnostic agreement between panoramic radiographs and color Doppler images of carotid atheroma.

The aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color Doppler images. Our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color Doppler images. Panoramic and color Doppler images of 16 patients obtained from the archives of the Health Department of the city of Valença, RJ, Brazil, were analyzed in this study. Both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. The level of agreement between diagnoses was analyzed using the Kappa statistics. There was a high level of agreement, with a Kappa value of 0.78. In conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. If properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment.

Diagnostic agreement between panoramic radiographs and color doppler images of carotid atheroma

The aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color Doppler images. Our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color Doppler images. Panoramic and color Doppler images of 16 patients obtained from the archives of the Health Department of the city of Valença, RJ, Brazil, were analyzed in this study. Both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. The level of agreement between diagnoses was analyzed using the Kappa statistics. There was a high level of agreement, with a Kappa value of 0.78. In conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. If properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment.

Estudo comparativo da cefalometria do perfil tegumentar com base na análise facial de Arnett relacionada à horizontal verdadeira com a realizada a partir do plano de Frankfurt horizontal / A comparative study of the cephalometric of the soft tissue profile based on Arnett’s facial analysis in relation to the true horizontal as this has been put into practice starting from the Frankfurt horizontal plane

Nesta pesquisa foi comparada a diferença das medidas obtidas utilizando-se a análise cefalométrica do perfil tegumentar tendo como base a análise facial de Arnett relacionada à Horizontal Verdadeira com a análise cefalométrica do perfil tegumentar feita a partir do Plano de Frankfurt. Utilizamos 140 radiografias cefalométricas requisitadas como parte de documentação ortodôntica, obtidas de pacientes com idade variando de 06 a 49 anos, sendo 64 do sexo masculino e 76 do sexo feminino, pertencentes ao arquivo do IOM - (Instituto de Odontologia Multidisciplinar) – RJ. As radiografias cefalométricas em norma lateral foram obtidas pelo mesmo operador, obedecendo ao protocolo adotado pelo IOM. Todos os pacientes foram orientados a assumir a Posição Natural da Cabeça, tendo como referência um espelho posicionado a frente e a Linha Vertical Verdadeira foi obtida por meio da utilização de um fio metálico unido à um prumo de chumbo, posicionado próximo à margem anterior do chassi porta-filme, de forma que apareça à frente do perfil tegumentar do paciente. A partir das medidas lineares obtidas nas Análises Cefalométricas dos Tecidos Moles, foram realizadas análises estatísticas visando dois objetivos: comparar as medidas de A à I obtidas nos traçados (um utilizando como referência uma perpendicular ao Plano Horizontal de Frankfurt e o outro à Linha Vertical Verdadeira) e analisar os resultados comparativamente. Após a análise estatística (Kolmogorov-Smirnov, para distribuição normal de dados; t-Student para amostras emparelhadas e teste não paramétrico de Wilcoxon) e a interpretação dos resultados obtidos, concluímos que houve diferenças significantes entre as formas de medidas das variáveis A, B, C, D, F, G e I, pois o valor do nível descritivo (p-valor) se apresentou abaixo de 0,05. Entretanto para as medidas E e H o valor do nível descritivo (p-valor) se apresentou maior que 0,05, demonstrando não haver diferenças significantes entre as formas dessas medidas. As cor...