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Data de sfârșit:

septembrie 23, 2015

If you’re sitting down, don’t sit still

New research finds that fidgeting can be healthy. So, just do it! ; © panthermedia.net/ Wavebreakmedia ltd

New research, co-led by the University of Leeds and UCL, suggests that the movements involved in fidgeting may counteract the adverse health impacts of sitting for long periods.

In a study published in the American Journal of Preventive Medicine, a team of researchers report that an increased risk of mortality from sitting for long periods was only found in those who consider themselves very occasional fidgeters.

They found no increased risk of mortality from longer sitting times, compared to more active women, in those who considered themselves as moderately or very fidgety.

The study examined data from the University of Leeds’ UK Women’s Cohort Study, which is one of the largest cohort studies of diet and health of women in the UK.

Study co-lead author Prof. Janet Cade, from the School of Food Science and Nutrition at the University of Leeds said: „While further research is needed, the findings raise questions about whether the negative associations with fidgeting, such as rudeness or lack of concentration, should persist if such simple movements are beneficial for our health.”

Even among adults who meet recommended physical activity levels and who sleep for eight hours per night, it is possible to spend the vast majority of the day (up to 15 hours) sitting down.

The study builds on growing evidence suggesting that a sedentary lifestyle is bad for your health, even if you are physically active outside work.

Breaks in sitting time have previously been shown to improve markers of good health, such as body mass index and your body’s glucose and insulin responses. But until now, no study has ever examined whether fidgeting might modify an association between sitting time and death rates.

The University of Leeds’ UK Women’s Cohort Study gathered information on a wide range of eating patterns of more than 35,000 women aged 35 to 69 who are living in the UK.

The new study analyses data from a follow-up survey sent to the same women, which included questions on health behaviours, chronic disease, physical activity levels and fidgeting. More than 14,000 responses were received.

Study co-lead author Dr Gareth Hagger-Johnson from UCL, who conducted the data analysis, said: „Our results support the suggestion that it’s best to avoid sitting still for long periods of time, and even fidgeting may offer enough of a break to make a difference.”

Source: www.medica.de


Unexpected link between choroid plexus and chronic pain

The choroid plexus located in the brain ventricle is marked with red in the brain image. The volume of the choroid plexus was measured in this work. The dots in the graph show the volume of the choroid plexus in patients with CRPS (on the left) and healthy control subjects (on the right). Each point corresponds to a single person; © Aalto University

An observation by Finnish researchers shows that the central nervous system plays an important role in complex regional pain syndrome (CRPS).

Aalto University neuroscientists, in collaboration with researchers at Helsinki University Hospital and Harvard Medical School, have found a novel connection between the size of the choroid plexus in the brain and complex regional pain syndrome (CRPS). The findings were recently published in the Scientific Reports online journal.

„When studying magnetic resonance images of the brains of patients suffering from CRPS, we noticed that the choroid plexus was nearly one-fifth larger in patients than in healthy control subjects,” says Postdoctoral Researcher Guangyu Zhou from Aalto University Department of Neuroscience and Biomedical Engineering (NBE), who analysed the images.

Located in the walls of the brain ventricles, the choroid plexus is best known for producing cerebrospinal fluid, which forms a protective mechanical cushion and immunological buffer for the brain. It also controls the passage of many substances from the blood into the cerebrospinal fluid, brain, and spinal cord.

„However, in clinical neuroscience, the functions of choroid plexus beyond cerebrospinal fluid generation have been largely neglected; for example, the size of the choroid plexus is not quantified in routine brain scans,” explains Prof. Riitta Hari, who was in charge of the research.

„As the choroid plexus is known to mediate the interaction between inflammation in the periphery of the body and in the brain, it is an interesting and important target for future research of chronic pain and CRPS in particular,” continues Hari.

Regional pain syndrome is a chronic and highly debilitating condition that typically develops after a minor trauma, to the hand for example, and then spreads to other areas, such as the whole upper limb and sometimes even to the other side of the body. Thus, it has been suggested earlier that the central nervous system might play an important role in the disease.

The scientists measured the volume of the choroid plexus from 3-tesla structural magnetic resonance images. The study involved 32 subjects, half of whom suffered from the syndrome and half of whom were healthy.

Source: www.medica.de

Industrial therapists in hospitals: changing structures Interview with Dr. Carsten P. Ostendorp, Center for Industrial and Organizational Psychology in Hospitals

Carsten P. Ostendorp specializes in studying and consulting hospitals for more than ten years. Aside from his work at ZAK, he is a contributor for the quality and risk management department at the Kantonsspital St. Gallen; © private

Hospitals only achieve a high level of patient safety if the workplaces of all their employees are optimally designed. Things can become life-threatening when doctors and nursing staff have not been properly trained – or when unnecessary interruptions in the operating room cause mistakes. Dr. Carsten Ostendorp at the Center for Industrial and Organizational Psychology in Hospitals, ZAK (German: Zentrum für Arbeitspsychologie und Organisationspsychologie in Kliniken) spoke about this topic with MEDICA.de.

Dr. Ostendorp, how did the collaboration with hospitals come to be?

Carsten P. Ostendorp: The idea originated with a doctor friend of mine who frequently complained about hospital situations that pertained to the collaboration between the physician team or advanced and continuing education for example. I offered my professional expertise since industrial and organizational psychology provides options to work on the various issues that play a significant role in hospitals. In this concrete example, the hospital complained that it was not able to provide expert advanced and continuing education for its resident physicians. That’s why we began to take a look at the structures and processes from an industry psychology perspective. In this instance, we focus on the work task a physician or a team needs to handle. We put it into a systemic correlation. We refer to ”human-technology-organization“ in this case. The methods of industrial psychology that we use in this sociotechnical approach to human-technology-organization are highly evidence-based and able to prove effectiveness.

Long distances, many interruptions, general bustle. Working in hospitals can be a challenge. The good news is, that malfunctioning structures can be changed! © panthermedia.net/DragonImages

Can you give us an example of how you approach an analysis?

Ostendorp: We ask ourselves how the task is designed. What do interfaces to other tasks look like? To find out, we accompany medical specialists or heads of departments for one day for example. We call this a job analysis. A prior defined classification system assists in categorizing the tasks a physician performs throughout the day. In a job analysis, we show that the distances employees overcome already take up 10 percent of their working hours in some hospitals, that patient-related administrative tasks take up a lot of working time and that relatively little time remains for medical measures for example. This gives us an indication that A. the layout isn’t right, B. there are contradicting tasks and C. we have to specifically analyze the processes and structures on the work system level. Another aspect are work interruptions. We know that interruptions are very problematic in the working process and trigger stress on the psychological and physiological level. On the one hand, it makes us forget things we actually wanted to do. This causes mistakes and the impression the human being is to blame for these mistakes. Oftentimes they are not the ones responsible but rather the structure that surrounds them. When you design tasks and work systems properly, interruptions in daily work life can be significantly reduced. On the other hand, we need additional time and energy to resume the interrupted task again and continue. Of course, there are interruptions that are an innate part of the task, especially in hospitals if an emergency occurs at a station for instance. Interruptions in the operating room, however, can do great harm and are about as dangerous as lack of hygiene for example. You can define the best and highest standard of hygiene, but when the doctor is frequently interrupted, increased infections or other unwanted events can occur.

That sounds dangerous. How do you initiate changes?

Ostendorp: We work based on the conditions. That means, we first look at the context the task is embedded in and try to design the conditions in a way to where humans are supported in managing the task. We subsequently take a look at the individual person whom we are able to help with additional training or advanced and continuing education. However, when the negative conditions are not being changed, any type of continuing education is only a compensatory measure.

Among other things, you offer training courses for physicians that include special operating room techniques, such as percutaneous spinal surgery for example. How did this specialization come to be?

Ostendorp: The backdrop for these courses was one physician’s realization that advanced training and continuing education in surgical techniques is very unsystematic and that surgeons at his hospital take a long time to learn a new minimally-invasive procedure for instance. This is why the learning curve of physicians was meant to be improved and time and effort as well as stress reduced at the same time. Initially, I looked at the procedure from a cognitive psychology perspective and searched for physicians who perform this procedure at a very high level and are the experts so to speak. I conducted structured interviews with these physicians and performed knowledge analyses. We found out that the discrepancies in surgical skills between the physicians are very significant – their skill levels ranged from that of a soccer player playing in a regional league to that of one playing in the major league as it were. All of the physicians who participated in the cognitive analysis enjoyed a high reputation among their peers. The differences in skill levels are unusual when all physicians share the same learning biography – medical degree, specialty training, and corresponding continuing education courses. This is why we designed advanced training courses together with surgeons and interventional physicians that focus on cognitive psychology as well as learning and educational science aspects.

One concrete example of this: a physician who checked whether the patient is properly positioned as it relates to the patient’s spine anatomy prior to performing a percutaneous spinal procedure has a significantly easier time during the surgery than a physician who didn’t check this positioning. The spine needs to be optimally positioned during C-arm imaging. Otherwise, the physician simply does not see enough on the X-ray. Yet the poorer the images are on the monitor which is influenced by the positioning, the more time the physician is going to need during the surgery to take X-rays. The length of X-radiation required by a physician who strives for the highest level of professionalism and one who is at a provisional plateau can range between 20 seconds and nine minutes for comparable patients. To a learning psychologist, this time difference is an indication that the skill level differs. Our job, therefore, is to identify this knowledge relevant to performance and operation and impart it in our courses to all physicians at the highest level possible.

The interview was conducted by Simone Ernst and translated by Elena O’Meara.

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