Musculoskeletal symptoms and job strain among nursing personnel: a study over a three year period

OBJECTIVES: To examine the variation of symptoms from the neck, shoulders, and back over a three year period among female nursing personnel and the relation between job strain and musculoskeletal symptoms. METHODS: At a county hospital the female nursing personnel answered a questionnaire at baseline and then once a year over a period of three years. There were 565, 553, 562, and 419 subjects who answered the questionnaire at the first, second, third, and fourth survey, respectively. Of the study group, 285 nursing personnel answered the questionnaire on four occasions. Ongoing symptoms of the neck, shoulders, and back were assessed by means of a 10 point (0-9) scale with the verbal end points "no symptoms" and "very intense symptoms." Cases were defined as nursing personnel reporting ongoing symptoms, score > 6, from at least one of the body regions. For assessments of job strain, a Swedish version of Karasek and Theorell's model was used. RESULTS: Of the 285 subjects, 13% were defined as cases at all four assessments, and 46% varied between cases and not cases during the study period. In the repeated cross sectional surveys the estimated rate ratio (RR) for being a case was between 1.1 and 1.5 when comparing the group with job strain and the group without job strain. For the combination of job strain and perceived high physical exertion the estimated RR was between 1.5 and 2.1. When the potential risk factors were assessed one, two, or three years before the assessment of symptoms the estimated RR for becoming a case was between 1.4 and 2.2 when comparing the group with job strain and the group without job strain. CONCLUSION: Almost half of the healthcare workers varied between being a case and not, over a three year period. The analysis indicated that job strain is a risk factor for musculoskeletal symptoms and that the risk is higher when it is combined with perceived high physical exertion.     

Retro-aldol degradations of unsaturated aldehydes: Role in the formation ofc4-heptenal fromt2,c6-nonadienal in fish,oyster and other flavors

Alterations of cucumber-, melon-like notes in aromas and flavors caused by retro-aldol degradations oft2,c6-nonadienal were confirmed using gas chromatographic measurements of volatile compounds in model systems. The data indicated that 3-hydroxy-c6-nonenal was formed first by the addition of water to the alpha/beta double bond oft2,c6-nonadienal, and this was followed by a retro-aldol condensation of 3-hydroxy-c6-nonenal to yieldc4-heptenal and ethanal. Compared to the reaction rate in aqueous systems at neutral pH, formation ofc4-heptenal was enhanced substantially at alkaline pH, but was greatly diminished at acidic pH values. Heating (to 90 C) of aqueous model systems oft2,c6-nonadienal held at neutral pH also enhanced the rate of formation ofc4-heptenal substantially compared to that at ambient temperature (21 C). Rates of formation ofc4-heptenal in aqueous model systems held under air or nitrogen atmospheres were similar.c4-Heptenal was not formed whent2,c6-nonadienal was held at 21 C for 96 hr under air or nitrogen in nonaqueous commercial corn oil. This paper is based on research supported by the College of Agriculture and Life Sciences and the Sea Grant Program, University of Wisconsin-Madison.     

An episode of ventricular tachycardia during long-duration spaceflight

An episode of nonsustained ventricular tachycardia was recorded from a crew member during the second month aboard the MIR space station. Although asymptomatic, this cardiac event increases the concern that serious cardiac dysrhythmias may be a limiting factor during long-duration spaceflight.     

Difficult parents. From adversaries to partners

The pediatrician's job becomes frustrating when it is necessary to deal with difficult parents. Some physicians may not have the training or inclination to engage such parents in a therapeutic partnership. This paper discusses tools available to physicians which will help them develop an effective partnership that includes uncovering the hidden meaning behind a child's illness; understanding the reciprocal nature of partnerships; and the importance of determining each party's goals, roles, and expectations. Negotiating these steps enables physicians to develop a productive relationship with difficult parents of sick children. This strategy can facilitate the child's medical care and improve the parents' and physician's satisfaction with the services rendered. This paper also discusses steps to take when these attempts are not sufficient to handle the situation.     

Long-term outcome of kidney-pancreas transplant recipients with good graft function at one year

To assess the long-term outcome of kidney/pancreas transplantation, patients were identified who had good graft function at one year posttransplant and a minimum of 3 years' follow-up. Fifty recipients from 1987-92 met these criteria. Records were reviewed for graft survival, graft function, readmissions, and medical complications. Psychosocial adjustment and quality of life were assessed using the SCL-90-R and SIP surveys, respectively. Patient, kidney, and pancreas survivals were 94%, 86%, and 85% at five years (Kaplan-Meier), with a mean follow-up of 4.3 years. The 3 deaths were due to 2 sudden arrests at home (presumed to be cardiac events) and 1 episode of sepsis. Other graft losses were due to rejection, except for one case of sepsis. The remaining patients are normoglycemic (glucose 92 +/- 23 mg/dl) and have a creatinine of 1.8 +/- 0.6 mg/dl. Mortality after the first year was 0.9%/year. Estimated kidney and pancreas half-lives were 15 +/- 2 and 23 +/- 7 years, respectively. Hospitalization, acute rejection, graft pancreatitis, dehydration, and severe infections all decreased dramatically after the first year. While CMV was the most common infection in the first year, foot infections predominated thereafter. Retinal hemorrhage was infrequent. Sudden death (presumably cardiac) was the chief cause of mortality, while peripheral vascular disease resulted in several amputations. Fractures were common, suggesting the need for increased attention to bone demineralization. Psychosocial and quality of life evaluations were within normal limits. In conclusion, most complications specifically related to transplantation occur in the first year, but underlying disease renders these patients susceptible to a variety of cardiovascular, bone, and other disorders.     

An improved equation for ionospheric absorption

The absorption equation of Laitinen and Haydon is limited to frequencies above about 5 MHz. Analysis of the data has led to a new equation which extends the lower limiting frequency to 2 MHz.