Effects of Vibration on the Hand-Arm System of Miners in India

Sixty-six Jackhammer drillers and 35 blasters from two mineswere clinically screened for hand-arm vibration syndrome (HAVS).The screening consisted of questionnaire-based information,clinical examination including measurement of phalangeal circumferencesof fingers (FCT) and motor nerve conduction (MCV) studies. Ina warm environment, the prevalence of symptom complexes suggestedthe existence of peripheral neuropathy and musculoskeletal abnormalitiesrather than any peripheral circulatory disorders. Clinical examinationrevealed soft tissue wasting in the hands (26 cases), ulnarnerve impairment (23 cases), median nerve impairment (16 cases)and Dupuytren's contracture (4 cases). Mean motor nerve conductionvelocities of 59 out of 66 drillers who volunteered for thisassessment were not significantly different from those of the35 blasters. The results of their correlation coefficients variedconsiderably for MCVs when age and years of vibration exposureunderwent regression analysis. However, comparison of MCV andFCT of 30 drillers with 30 matched blasters revealed that themean MCV of the right median nerve in the vibration exposedgroup was significantly decreased (<0.01) and for the meanFCT, the proximal phalanxes of the right index finger, leftthumb and left ring fingers were thinner in the vibration exposedgroup (<0.05). Received        1 November 1994 Accepted       29 September 1995     

Relationship between body weight and the incidence of positive axillary nodes at mastectomy for breast cancer

The question, whether obesity is associated with an increased incidence of positive axillary nodes at mastectomy for breast cancer, was studied in two quite different hospital populations; one from a large urban teaching hospital (Montefiore) and one from a medium-sized Air Force medical center (Malcolm Grow). In the Montefiore population, the answer was "yes"; 67% of the node-positive patients, but only 31% of the node-negative patients were obese (20% or more above ideal weight) (p less than 0.05). In the Malcolm Grow population, the answer was "no"; 20% of the node-positive and 20% of the node-negative patients were obese. The different answers, we believe, are due to the biological differences between the populations; the Montefiore population was shorter (by an average of 1.7 inches), heavier (by an average of 20 lbs), and more obese. The incidence of obesity was about three times as high in the Montefiore population (52% versus 20%; p less than 0.02) and it contained a statistically distinct subpopulation of obese patients, while the few obese patients in the Malcolm Grow population constituted merely the upper tail of a unimodal log-normal distribution of weight in that population. We propose that it is possible to demonstrate a relationship of obesity to node-positivity in the Montefiore population but not in the Malcolm Grow population because obesity was highly prevalent in the former and almost nonexistent in the latter. It seems self-evident that it is not possible to demonstrate an effect of obesity in a population if that population manifests no significant obesity, statistically speaking, but disregarding this principle, we believe, may account for the controversy in the literature about whether obesity is a risk factor in breast cancer.     

HEPATOPROTECTIVE EFFECT OF AMOORA ROHITUKA

Abstract

Antihepatotoxic activity of a resuspended residue of the alcohol extract of Amoora rohituka W & A. (Meliaceae) was studied in rats with hepatic injury induced by carbon tetrachloride. Carbon tetrachloride (1 ml/kg, i.p.) was administered twice a week for 3 weeks and an extract of A. rohituka (50 mg/kg/day) was given orally for the same period. The rats were sacrificed 24 h after the last CC1₄ challenge. Carbon tetrachloride induced elevations of alkaline phosphatase (ALP), glutamate pyruvate transaminase (CPT), alanine aminotransferase (ALAT), glutamate oxaloacetate transaminase (GOT), aspartate aminotransferase (ASAT) and lactate dehydrogenase (LDH) and total plasma bilirubin concentration as well as depression of total plasma cholesterol concentration were reduced significantly by the concurrent treatment of rats with A. rohituka suspension. Changes in the histological architecture of the liver produced by CC1₄ where also protected by the administration of A. rohituka suspension. These results indicate that A. rohituka suspension possesses hepatoprotective action.     

Burnout and work‐life balance among pediatric cardiologists: A single center experience

Background: Physicians are exposed to workplace factors that may result in acute or chronic stress resulting in burnout. This may impact the productivity and result in suboptimal patient care practices.
Methods: We surveyed pediatric cardiology attending physicians at our institution to assess their perception of burnout and work-life balance using the Maslach Burnout Inventory and the Areas of Work-Life Survey.
Results: Forty-five out of the 50 pediatric cardiology attendings responded to the survey. They were divided into 4 groups: Interventional/Electrophysiology [n = 3], Cardiac Intensive Care/Inpatient [n = 8], Non-Invasive Imaging [n = 6], and Outpatient [n = 28]. The Maslach Burnout Inventory demonstrated group-specific scores in the areas of emotional exhaustion, depersonalization, and personal accomplishment that were all significantly better than the general population. However, group-specific Areas of Work-Life Survey results demonstrated concerning findings with respect to the perception of work-life balance.
Conclusions: Although the Maslach Burnout Inventory did not demonstrate significant burnout among the attending physicians, the Areas of Work-Life Survey results demonstrated reduced work engagement, which can impact patient care and lead to burnout in the future. Based on these results, we plan to implement strategies to help increase work engagement and improve overall organizational effectiveness.     

Encoded Exposure and Social Norms in Entertainment-Education

Entertainment-education is an effective health communication strategy that combines or embeds educational messages into entertainment programs to bring about social and behavior change. For years, scholars have considered how entertainment-education works. Some contemporary theories posit that entertainment-education does not engender behavior change directly but does so through mediating variables. This study adds to the literature on this topic by exploring the direct relationship between exposure and social norms instead of their relationship through behavior as a mediator. Novel to this study is the use of encoded exposure, a continuous and recognition-based measure of exposure that includes ever watching, recall, involvement, and dose in its operationalization. Using cross-sectional data from Kyunki … Jeena Issi Ka Naam Hai, an entertainment-education program in India, this exploratory analysis indicates a positive and significant relationship between encoded exposure and social norms. How can this finding be applied to future programs? Questions remain, and replication is needed, but if it is not essential to go through behavior in order to change social norms, then implications emerge for the theory and practice of entertainment-education.