Publications

BACKGROUND

Assessing the physical demands of the heterogeneous jobs in hospitals requires appropriate and validated assessment methodologies.

METHODS

As part of an integrated assessment, we adapted Rapid Entire Body Assessment (REBA), using it in a work sampling mode facilitated by a hand-held personal digital assistant, expanding it with selected items from the UC Computer Use Checklist, and developed a scoring algorithm for ergonomics risk factors for the upper (UB) and lower body (LB).

RESULTS

The inter-rater reliability kappa was 0.54 for UB and 0.66 for LB. The scoring algorithm demonstrated significant variation (ANOVA p<0.05) by occupation in anticipated directions (administrators ranked lowest; support staff ranked highest on both scores). A supplemental self-assessment measure of spinal loading correlated with high strain LB scores (r=0.30; p<0.001).

CONCLUSION

We developed and validated a scoring algorithm incorporating a revised REBA schema adding computer use items, appropriate for ergonomics assessment across a range of hospital jobs.

Low socioeconomic status (SES) is associated with poor health outcomes in patients who have coronary heart disease (CHD). Inflammation is a potential mechanism by which low SES may lead to adverse cardiovascular outcomes, but it is not known whether low SES is associated with inflammation in patients who have CHD. We measured high-sensitivity C-reactive protein (CRP) levels in a cross-sectional study of 985 adults who had CHD. Income and education were determined by self-report. We used ordinal logistic regression to examine the association of income and education with CRP. Of the 985 participants, 390 had high CRP levels (>3 mg/dl). The proportion of participants who had high CRP levels ranged from 30% (103 of 340) in those who had a college degree to 51% (65 of 127) in those who had less than a high school degree (p<0.0001). The proportion of subjects who had a high CRP level ranged from 28% (52 of 183) in those who had annual income>or=$50,000 to 42% (199 of 974) in those who had an annual income<$20,000 (p<0.001). After adjustment for traditional cardiovascular risk factors and other potential confounding variables, lower income and education remained associated with higher CRP levels. In conclusion, low SES is associated with high CRP levels in patients who have CHD. This observation raises the possibility that inflammation may contribute to the adverse cardiovascular outcomes associated with low SES.

Domoic acid is a rigid analog of the neurotransmitter glutamate and a potent agonist of kainate subtype glutamate receptors. Persistent activation of these receptor subtypes results in rapid excitotoxicity, calcium dependent cell death and neuronal lesions in areas of the brain where kainate pathways are concentrated. To better understand responses to domoic acid induced excitotoxicity, microarrays were used to profile gene expression in mouse brain following domoic acid exposure. Adult female mice were subjected intraperitoneally to domoic acid at the lethal dose 50, killed and dissected at 30, 60 and 240 min post-injection. Total brain RNA from treated mice was compared with time-matched controls on Agilent 22K feature microarrays. Real-time PCR was performed on selected genes. For the 30, 60 and 240 min time points, 3.96%, 3.94% and 4.36% of the genes interrogated were differentially expressed (P-value < or = 0.01), respectively. Rigorous filtering of the data resulted in a set of 56 genes used for trending analysis and K-medians and agglomerative clustering. The earliest genes induced consisted primarily of early response gene families (Jun, Fos, Ier, Egr, growth arrest and DNA damage 45) and the inflammatory response element cyclooxygenase 2. Some later responding genes involved glucocorticoid responses (Gilz, Sgk), cold inducible proteins (Cirbp, Rbm3), Map kinases (Map3k6) and NF-kappaB inhibition. Real-time PCR in male mice from an additional study confirmed the expression of several of these genes across gender. The transcriptional profile induced by domoic acid shared similarity with expression profiles of brain ischemia and other excitotoxins, suggesting a common transcriptional response.