Physiological guidelines for the design of manual lifting and lowering tasks: the state of the art

The goal of many researchers and practitioners of occupational health and safety has been to design manual materials handling (MMH) tasks so as to reduce the frequency and severity of overexertion injuries usually associated with these types of tasks. Physiological limits with respect to the manual lifting and lowering aspects of MMH have been reviewed and evaluated. The information provided by different researchers has been presented in a concise manner that is easily accessed by designers and practitioners of MMH. Recommendations for future research in determining physiological limits of individuals engaged in manual lifting and lowering tasks and other aspects of MMH activities have been provided.     

Efficacy of the North American guidelines for children's agricultural tasks in reducing childhood agricultural injuries

OBJECTIVES: We assessed whether active dissemination of the North American Guidelines for Children's Agricultural Tasks (NAGCAT) reduced childhood agricultural injuries. METHODS: In this randomized controlled trial, lay educators visited intervention farms to review NAGCAT. New York State farms with resident or working children were randomized. Control farms were visited only to collect baseline data. Data on childhood injuries, tasks, and hours worked were obtained quarterly for 21 months. Injury rates per farm were compared between the treatment and control groups, along with time span to occurrence of an injury and to violation of NAGCAT age guidelines. RESULTS: Intervention farms were less likely than control farms to violate NAGCAT age guidelines in the areas of all-terrain-vehicle use and tractor and haying operations. Cox proportional hazards regression models showed a significant protective effect of the intervention on preventable injuries after adjustment for important covariates. CONCLUSIONS: Our results showed that dissemination of NAGCAT reduced rates of work-related childhood agricultural injuries. A comprehensive public health approach is needed to reduce non-work-related childhood injuries.     

Physicians contracting with managed care, Medicare, and Medicaid

Managed care has become an ever important form of health care delivery, yet little is known about the characteristics of providers contracting with managed care organizations. Using data from a national survey of 4,729 physicians, we find that market conditions, specialty, and sociodemographics all affect a physician's decision to contract with managed care. Moreover, most of these characteristics also have similar effects on a physician's decisions to participate in Medicare and Medicaid. The latter result implies that physicians view managed care, Medicare, and Medicaid similarly when making contracting decisions, although financial incentives in these insurance programs are different.