Search

Professional musicians have high rates of musculoskeletal pain, but few studies have analysed risks by work activities or the psychosocial work environment.To assess the prevalence and impact of musculoskeletal pain, and its relation to playing conditions, mental health and performance anxiety, in musicians from leading British symphony orchestras.Musicians from six professional orchestras completed a questionnaire concerning their orchestral duties and physical activities at work, mental health (somatizing tendency, mood, demand, support and control at work, performance anxiety) and regional pain in the past 4 weeks and past 12 months. Prevalence rates were estimated by anatomical site and associations with risk factors assessed by logistic regression.Responses were received from 243 musicians (51% of those approached), among whom 210 (86%) reported regional pain in the past 12 months, mainly affecting the neck, low back and shoulders. Risks tended to be higher in women, in those with low mood, and especially in those with high somatizing scores. Only weak associations were found with psychosocial work stressors and performance anxiety. However, risks differed markedly by instrument category. Relative to string players, the odds of wrist/hand pain were raised 2.9-fold in wind players, but 60% lower in brass players, while the odds of elbow pain were 50% lower among wind and brass players.Musculoskeletal pain is common in elite professional musicians. A major personal risk factor is somatizing tendency, but performance anxiety has less impact. Risks differ substantially by instrument played, offering pointers towards prevention.

BACKGROUND: National initiatives to prevent and/or manage sickness absence require a database from which trends can be monitored. AIMS: To evaluate the information provided by surveillance schemes and publicly available data sets on sickness absence nationally from musculoskeletal disorders (MSDs). METHODS: A grey literature search was undertaken using the search engine Google, supplemented by leads from consultees from academia, industry, employers, lay interest groups and government. We abstracted data on the outcomes and populations covered and made quantitative estimates of MSD-related sickness absence, overall and, where distinguishable, by subdiagnosis. The coverage and limitations of each source were evaluated. RESULTS: Sources included the Labour Force Survey (LFS) and its Self-reported Work-related Illness survey module, the THOR-GP surveillance scheme, surveys by national and local government, surveys by employers' organizations and a database of benefit statistics. Each highlighted MSDs as a leading cause of sickness absence. Data limitations varied by source, but typically included lack of diagnostic detail and restriction of focus to selected subgroups (e.g. work-ascribed or benefit-awarded cases, specific employment sectors). Additionally, some surveys had very low response rates, were completed only by proxy respondents or ranked only the perceived importance of MSD-related sickness absence, rather than measuring it. CONCLUSIONS: National statistics on MSD-related sickness absence are piecemeal and incomplete. This limits capacity to plan and monitor national policies in an important area of public health. Simple low-cost additions to the LFS would improve the situation.

Background Early detection and treatment of melanoma is important for optimal clinical outcome, leading to biopsy of pigmented lesions deemed suspicious for the disease. The vast majority of such lesions are benign. Thus, a more objective and accurate means for detection of melanoma is needed to identify lesions for excision.

BACKGROUND: To identify opportunities for targeted prevention, we explored differences in occupational mortality from diseases and injuries related to alcohol consumption, sexual habits and drug abuse. METHODS: Using data on all deaths among men and women aged 16-74 years in England and Wales during 1991-2000, we derived age- and social class-standardized proportional mortality ratios (PMRs) by occupation for cause of death categories defined a priori as potentially related to alcohol consumption, sexual habits or drug abuse. RESULTS: The highest mortality from alcohol-related diseases and injuries was observed in publicans and bar staff (both sexes) and in male caterers, cooks and kitchen porters and seafarers. Male seafarers had significantly elevated PMRs for cirrhosis (179), 'other alcohol-related diseases' (275), cancers of the liver (155), oral cavity (275) and pharynx (267) and injury by fall on the stairs (187). PMRs for human immunodeficiency virus infection (HIV)/acquired immunodeficiency syndrome (AIDS) were particularly high in tailors and dressmakers (918, 95% CI: 369-1890, in men; 804, 95% CI: 219-2060, in women) and male hairdressers (918, 95% CI: 717-1160). Most jobs with high mortality from HIV/AIDS also had more deaths than expected from viral hepatitis. Of seven jobs with significantly high PMRs for both drug dependence and accidental poisoning by drugs, four were in the construction industry (male painters and decorators, bricklayers and masons, plasterers, and roofers and glaziers). CONCLUSIONS: Our findings highlight major differences between occupations in mortality from diseases and injuries caused by alcohol, sexual habits and drug abuse. Priorities for preventive action include alcohol-related disorders in male seafarers and drug abuse in construction workers. Language: en

Objectives To assess occupational risk factors for carpal tunnel syndrome (CTS), we conducted a systematic literature review. Methods We identified relevant primary research from two major reviews in the 1990s and supplemented this material by a systematic search of the MEDLINE and EMBASE biomedical databases from the start of the electronic record to 1 January 2005. Reports were obtained and their bibliographies checked for other relevant publications. From each paper, we abstracted a standardized set of information on study populations, exposure contrasts and estimates of effect. Results Altogether, we summarized 38 primary reports, with analyses based either on a comparison of job titles (22) or of physical activities in the job (13) or both (3). We found reasonable evidence that regular and prolonged use of hand-held vibratory tools increases the risk of CTS >2-fold and found substantial evidence for similar or even higher risks from prolonged and highly repetitious flexion and extension of the wrist, especially when allied with a forceful grip. The balance of evidence on keyboard and computer work did not indicate an important association with CTS. Discussion Although the papers that we considered had limitations, a substantial and coherent body of evidence supports preventive policies aimed at avoiding highly repetitive wrist–hand work. There is a case for extending social security compensation for CTS in the United Kingdom to cover work of this kind.

OBJECTIVES: To assess occupational associations with tenosynovitis and epicondylitis, we conducted a systematic literature review. We focused particularly on evidence that might support compensation of these disorders 'on the balance of probabilities'. METHODS: We searched the MEDLINE and EMBASE electronic biomedical databases to 1 January 2005 using combinations of keyword and medical subject headings, and also the references cited in two state-of-the-art reviews from the 1990s. Primary research reports were retrieved and checked for further relevant citations. From each paper, we abstracted a standardized set of information on study populations, exposure contrasts and estimates of effect. RESULTS: We found and summarized 18 papers. In the main, these based analysis on job titles rather than on directly assessed physical activities. Few occupations were studied more than once, however, and there was little consistent evidence of jobs or work activities that carried more than a doubling of risk for either disorder. CONCLUSION: Compensation of occupational illness can be problematic for disorders that are not specific to work and for which there are no distinctive clinical features in occupationally related cases. Attribution can, however, be made on the balance of probabilities if there is convincing evidence that risk is at least doubled in an occupational group. Our review highlights the relative lack of data to support such attribution for tenosynovitis and epicondylitis, and discusses the difficulty of compensating upper limb disorders

To test the hypothesis that inhalation of metal fume reversibly increases susceptibility to pneumonia, the authors conducted a case-control study. Men aged 20-64 years, admitted to 11 hospitals in West Midlands, England, with community-acquired pneumonia during 1996-1999 were interviewed about their lifetime occupational history, exposure to metal fume, and potential confounding factors. Similar information was collected from controls admitted to the same hospitals with nonrespiratory illness. For cases, exposures were timed relative to the onset of their illness (on average, 6 months before interview). Exposure histories for controls were censored 6 months before interview. Interviews were completed by 525 cases and 1,122 controls (response rates of 74% and 99%). Pneumonia was associated with reported occupational exposure to metal fume in the previous year (adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI): 1.1, 2.4) but not in earlier periods (OR = 1.1). The risk was highest for lobar pneumonia and recent exposure to ferrous fume (OR = 2.3, 95% CI: 1.2, 4.3). The association was not specific to any one microorganism. These findings support the hypothesis that ferrous and possibly other metal fumes reversibly predispose to infectious pneumonia. Research should now focus on the underlying mechanisms and prevention.

Following a catalogue of serious, highly publicized medical misdemeanours, the General Medical Council (GMC) has introduced plans for a new system of medical licensing in the UK called 'revalidation'. Under this, the onus will fall on individual doctors, including occupational physicians, to demonstrate their continuing fitness to practice. Doctors will need to show that they meet basic minimum standards in terms of the care they provide, their own continuing professional development, and other aspects of professional life like probity and ethical behaviour. As part of the process, the Faculty of Occupational Medicine, Royal College of Physicians, has produced its own guidance on good medical practice for occupational physicians, following an extensive consultation exercise. This paper summarizes the background to the initiative, the development process and the standards that have been recommended to aid professional accountability.

We examined a parthenogenetic strain of the hard tick Ixodes woodi Bishopp for the presence of endosymbiotic bacteria. Electron microscopic examination revealed the ovarian tissues and Malpighian tubules were infected with pleomorphic bacteria. Two basic types were observed: a larger granular cell and a smaller condensed cell. Cloning and sequence analysis of polymerase chain reaction (PCR) amplified 16S rRNA gene yielded a single sequence from bacteria present in I. woodi tissues. Phylogenetic analysis of the nearly complete 16S rDNA indicated that the ticks were infected with an endosymbiont belonging to the gamma subdivision of the Proteobacteria. It clustered with the insect pathogenic species Rickettsiella grylli (Vago and Martoja 1963) and the animal pathogen Coxiella burnetii (Derrick 1939) Philip 1948. Our results suggest that the I. woodi females harbored a single endosymbiotic bacterium related to selected Rickettsiella species and to C. burnetii.

The objective of this study was to examine the relationship between upper limb symptoms and keyboard use in a population survey. A questionnaire was mailed to 21,201 subjects aged 16-64 years, selected at random from the registers of 34 British general practices. Information was collected on occupation and on regular use of keyboards (for >4 h in an average working day), pain in the upper limbs and neck, numbness or tingling in the upper limbs, headaches, and feelings of tiredness or stress. Associations were explored by logistic regression, with the resultant odds ratios converted into prevalence ratios (PRs). Among 12,262 respondents, 4899 held non-manual occupations. These included 1871 regular users of keyboards (e.g. computer operators, data processors, clerks, administrators, secretaries and typists). Pain in the neck or upper limbs and sensory symptoms were common in the non-manual workers overall (with 1 week period prevalences of 30 and 15%, respectively), and were associated with older age, smoking, headaches and tiredness or stress. After adjustment for these factors, regular keyboard use was significantly associated with pain in the past week in the shoulders (PRs 1.2-1.4) and the wrists or hands (PR 1.4), but not with elbow pain or sensory symptoms over the same period, or with neck or upper limb pain that prevented normal activities in the past year. Disabling symptoms were somewhat less prevalent among symptomatic keyboard users than among other symptomatic workers. We conclude that use of keyboards was associated with discomfort at the shoulder and wrist or hand, but risk estimates were lower than generally reported in workplace surveys. Previous estimates of risk in the occupational setting may have been biased by shared expectations, concerns, or other aspects of illness behaviour.

We investigated controls over the emission of monoterpenes from two species of boreal forest conifers, black spruce (Picea mariana Miller (B.S.P.)) and jack pine (Pinus banksiana Lamb). Monoterpenes are important in plants as carbon-based defensive compounds and in the atmosphere as photochemically reactive compounds that affect ozone and carbon monoxide concentrations. We examined ecological theories of plant allocation to defensive compounds in relation to emission rates of monoterpenes from the foliage of these two species. Monoterpene emission from plants is controlled by the vapor pressure of the monoterpenes within plant tissues, and vapor pressure is controlled by two parameters, air temperature and terpene concentration within the tissues. We measured the concentration of terpenes and nitrogen within foliage and the emission rate from foliage, and demonstrated that emission rate was linearly related to nitrogen concentration and exponentially related to air temperature. Current theories of plant allocation to carbon-based defenses predict an inverse relationship between foliar nitrogen and carbon-based defenses. We found that, under certain circumstances, these theories were sufficient to predict concentrations and emissions, but under other circumstances, the theories did not predict monoterpene concentrations or emissions. These results are discussed in the context of landscape/regional modeling of hydrocarbon emission from vegetation.

The fundamental components of interpersonal transactions at the nonverbal level often include the cognitively held intention of one person to increase or decrease affiliation with his or her partner, the encoding of this intention into behavioral displays, and the decoding of the behavioral displays by the other. Nonverbal encoding of relational information may be conducted at less than conscious levels of information processing although intentions may be held consciously. A study was conducted in which naive confederates were induced to either increase or decrease their displays of liking for their partner. It was found that confederates’intentions to show increased or decreased liking toward their partners were positively correlated with the partners’liking for the confederate. However, less than one quarter of the confederates could demonstrate an accurate conscious awareness of the behaviors they used and how they used them. Of this small number, those who were given the conscious intention of showing decreased liking demonstrated the most conscious awareness of their nonverbal behaviors.

The discovery of nucleated erythrocytes in maternal circulation provides a potential source for non-invasive prenatal diagnosis. We have evaluated the use of a three-stage procedure to determine the number of cells that are of fetal rather than maternal origin. First, monoclonal antibodies specific for CD45 and CD14 were used in conjunction with a magnetic (MACS) column to deplete unwanted leukocytes from maternal blood. This was followed by a positive MACS enrichment for nucleated erythrocytes, using an anti-CD71 (transferrin receptor) monoclonal antibody. To discriminate between fetal nucleated erythrocytes and those of maternal origin, enriched fractions were simultaneously stained with an anti-fetal haemoglobin (HbF) antibody and hybridized with probes specific for X and Y chromosomes. Samples were then subjected to blind analysis along with negative control samples from non-pregnant volunteers. Using this dual analysis, we were able to determine that less than one nucleated erythrocyte per ml of maternal blood was of fetal origin. Small numbers of these fetal cells were found in 87.5% of pregnancies, ranging from 6 to 35 weeks gestational age. Comparison of HbF and X/Y probe data also suggests that the fetal cells are less suitable for fluorescence in-situ hybridization (FISH) analysis than similar preparations from other sources.

We report the world's first clinical pregnancy resulting from DNA-based enrichment for X-bearing human spermatozoa, for prevention of X-linked hydrocephalus. Sperm separation was followed by embryo biopsy and nested multiplex polymerase chain reaction (PCR) for gender determination. Enriched populations of X- bearing spermatozoa ranging from 80 to 89% pure as determined by fluorescence in-situ hybridization (FISH) resulted in in-vitro fertilization (IVF) rates indistinguishable from normal IVF procedures (65%). In two separate biopsy procedures, 7/9 and 15/16 of the resulting embryos were determined to be female by multiplex PCR. Embryo transfer resulted in a karyotypically normal female fetus. This technique should be widely applicable to gender selection for the prevention of genetic disorders

We contend that communication episodes tend to focus interactants’attention on one or the other of two relational judgments: dominance or affiliation. Further, when one judgment is relatively more salient, individuals will use the salient judgment as the basis for inferring other aspects of the relationship. To test that notion, a judgment study was conducted in which participants viewed a set of influence messages that varied in degree of dominance and explicitness. The influence context was chosen because it naturally highlighted dominance. After viewing the messages, participants provided ratings of dominance, explicitness, and two aspects of affiliation: liking and involvement. When the resulting data were submitted to a structural equation analysis, it was found that judgments of liking depended on judgments of explicitness and dominance. Judgments of involvement depended on judgments of liking and dominance. Both findings support the claim that one relational judgment may provide the basis for another.

We report the world's first clinical pregnancy resulting from DNA-based enrichment for X-bearing human spermatozoa, for prevention of X-linked hydrocephalus. Sperm separation was followed by embryo biopsy and nested multiplex polymerase chain reaction (PCR) for gender determination. Enriched populations of X- bearing spermatozoa ranging from 80 to 89% pure as determined by fluorescence in-situ hybridization (FISH) resulted in in-vitro fertilization (IVF) rates indistinguishable from normal IVF procedures (65%). In two separate biopsy procedures, 7/9 and 15/16 of the resulting embryos were determined to be female by multiplex PCR. Embryo transfer resulted in a karyotypically normal female fetus. This technique should be widely applicable to gender selection for the prevention of genetic disorders

ScienceFest is coordinated through the International JASON Project that introduces the world of science through live satellite broadcasts. Dr. Robert Ballard, the ocean explorer who found the Titanic, started the program in 1989. Included in the ScienceFest presentations at the John Ford Bell Museum of Natural History, Project MICRO run by the Minnesota Microscopy Society (MMS) was on display to the public. As in past years [1] the Project MICRO team of the MMS set up various microscope stations and invited the participants to record the things that they saw and to note what they learnt and mention the things they would like to see. The microscope stations are quite simple, low power ‘field’ microscopes and various samples as documented by the “Microscopic Explorations” [2] handbook that has been developed by the MSA in collaboration with the Lawrence Hall of Science [3] as part of their Great Explorations in Math and Science (GEMS) series.

Ticks harbor several different genera of endosymbiotic bacteria. These obligate intracellular bacteria, most of which appear to be nonpathogenic for the tick, persist in nature by being transmitted transovarially from generation to generation. Those in the genus Rickettsiabelong to the spotted fever group (SFG) of rickettsia which includes both mammalian pathogenic and nonpathogenic species. The species that cause spotted fevers in humans, e.g. Rickettsia rickettsii, are well characterized but those not known to cause disease remain poorly understood. Transmission electron microscopy on SFG rickettsia cultured in tick cell cultures offers a powerful way to examine dynamic host parasite interactions in these apparently nonpathogenic SFG species.We have successfully isolated two unknown, nonpathogenic rickettsia strains in tick cell lines. T2 was isolated from an Ixodes ricinus tick collected in the English Garden in Munich, Germany and is propagated in an Ixodes scapularis cell line, ISE6.

The cardiovascular and plasma catecholamine responses to oral glucose (50 g) ingestion were investigated in five elderly subjects with orthostatic hypotension and five elderly control subjects. All the orthostatic hypotension subjects showed blood pressure falls after glucose ingestion, as compared to only one of the control subjects. Significantly greater falls in the orthostatic hypotension as compared to control patients were observed for systolic blood pressure (P less than 0.01) at 60 and 90 min following glucose and mean blood pressure (P less than 0.05) at 60 min following glucose. The orthostatic hypotension subjects did not have evidence of reduced heart-rate or plasma catecholamine responses to the glucose ingestion. It is concluded that, in elderly patients with orthostatic hypotension, disorder of blood pressure control may also cause hypotension associated with eating.

Maine experienced a relatively good economic year in 1982. The unemployment rate was fairly stable, decreasing slightly from 8.3 percent in January to 8.0 percent in December. By contrast, the national unemployment rate increased during the year from 9.4 percent to 10.5 percent. Maine continued to resist the national trend, in part, because of its diversified economy, and no serious layoffs affected specific industries. The state ended the year with a general fund surplus of approximately $18 million, or about 4 percent of general fund revenues. This was a slight decline from the surplus level in 1981, partly because no new taxes were levied in 1982, and partly because a portion of the federal budget cuts was replaced with state funds. The rather strong economic showing in Maine was a major factor in the landslide reelection of Democratic Governor Joseph E. Brennan in November. The governor was handily reelected with 61 percent of the vote. In his campaign, the governor defended his record of economic development, which most observers agreed had been substantial. He also argued that Maine was making progress, despite the current federal administration. Governor Brennan remained a strong critic of President Reagan's domestic program. While he indicated, on occasion, a respect for the president's efforts to debate federalism issues, he disagreed with virtually all of the specific Reagan initiatives. Early in the year, Governor Brennan resisted the president's "swap" proposal, which called for assumption of the Medicaid program by the federal government in exchange for state responsibility for Aid to Families with Dependent Children (AFDC) and the Food Stamp program, on the grounds that such an exchange would cost Maine about $40 million per year. Governor Brennan argued further that under the proposed swap, "the quality of life for the poor, disabled and handicapped would depend on whether they reside in a rich or poor

Four cases of osteomalacia associated with the long term consumption of phenytoin (Dilantin) were admitted to a geriatric unit in a two-month period. No other cause for their disease was found. The diagnosis was made on biochemical data and no bone biopsy was obtained. Radiographic evidence was found in two cases only.