Journal articles on the topic 'Manual handling, Disability carers'

Abstract Introduction. Musculoskeletal disorders (MSDs) are the leading cause of work disability, sickness absence from work, and loss of productivity in healthcare across all the European Union (EU) member states. Aim. This article examines the available evidence on the economic burden of MSDs on informal carers in the UK and highlights areas of moving and handling practice. Summary. Such solutions might improve the outcomes for informal carers and their families, as well as reduce the economic costs of MSDs.

This paper focuses on information-driven engineering, where information is gathered by means of innovation for people and by the people. This case study was carried out on innovation of a manual wheelchair. Through active participation of person with disability (direct users) and their carers (indirect user), knowledge awareness of the early design was increased. Computer aided engineering tools were used for the development of virtual prototype (VP) and after further feedback from direct and indirect users design was adjusted. Additionally, Physical prototype was built to practically demonstrate the new features to users and finally the prototype was readjusted to bridge user requirement even more. This innovation process identifies additional improvement aspects and contributes beyond fundamental personal needs and increases well being.

Background: Musculoskeletal injuries, notably lower back injuries, are major occupational health problems among nurses. These injuries occur mainly due to incorrect use of body mechanics upon handling, lifting, and transfer of patients. It is the leading cause of occupational disability and is associated with increased healthcare costs. Reducing these injuries can lead to a significant reduction in healthcare costs.Purpose: This integrative literature review aims to examine the impacts of manual handling and lifting devices on the risk of back pain among hospital nurses.Methods: This study uses an integrative literature review design. Proquest, Science Direct, MEDLINE, and CINAHL were searched comprehensively. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow diagram was used to check the number of publications that were identified and screened for eligibility, and the number of publications excluded and reasons for exclusion. The Critical Appraisal Skills Programme (CASP) and the Centre for Evidence-Based Management critical appraisal checklist for a cross-sectional study (CEBM) were used to appraise the quality of selected articles.Results: Fifteen studies were found to highlight the importance of manual handling training programs and the consistent use of lifting devices in the prevention of low back pain. Ergonomics training, proper body mechanics and posture, use of body slings, workplace characteristics, availability of equipments and complexity of work, lost work days including nurses’ knowledge, experience, attitude and compliance are essential factors that impacts back pain.Conclusion: Manual handling training programs and the use of patient lifting equipment are effective in preventing lower back pain among nurses.

We investigated the kinetic features of manual dexterity and fine motor control during a task that resembles an activity of daily living in 30 persons with relapsing-remitting multiple sclerosis (PwMS). Specifically, a novel two-transducer system was used to measure time and grip-load forces during a bimanual task that is similar to opening and closing a jar. We hypothesized that PwMS would have increased grip force production, deteriorations in kinetic timing, and preserved grip-load coupling indices compared to healthy controls (i.e., young and older adults). Increased grip force production and deterioration in timing indices were confirmed in PwMS. Abnormal grip-load coupling was exhibited by PwMS, in contrast to healthy participants. The correlation between task time and self-reported disability scores suggests that objective measurement of impaired upper-extremity movements relates to perception of overall function.

(1) Background: Low back disorders are a leading cause of missed work and physical disability in manual material handling due to repetitive lumbar loading and overexertion. Ergonomic assessments are often performed to understand and mitigate the risk of musculoskeletal overexertion injuries. Wearable sensor solutions for monitoring low back loading have the potential to improve the quality, quantity, and efficiency of ergonomic assessments and to expand opportunities for the personalized, continuous monitoring of overexertion injury risk. However, existing wearable solutions using a single inertial measurement unit (IMU) are limited in how accurately they can estimate back loading when objects of varying mass are handled, and alternative solutions in the scientific literature require so many distributed sensors that they are impractical for widespread workplace implementation. We therefore explored new ways to accurately monitor low back loading using a small number of wearable sensors. (2) Methods: We synchronously collected data from laboratory instrumentation and wearable sensors to analyze 10 individuals each performing about 400 different material handling tasks. We explored dozens of candidate solutions that used IMUs on various body locations and/or pressure insoles. (3) Results: We found that the two key sensors for accurately monitoring low back loading are a trunk IMU and pressure insoles. Using signals from these two sensors together with a Gradient Boosted Decision Tree algorithm has the potential to provide a practical (relatively few sensors), accurate (up to r2 = 0.89), and automated way (using wearables) to monitor time series lumbar moments across a broad range of material handling tasks. The trunk IMU could be replaced by thigh IMUs, or a pelvis IMU, without sacrificing much accuracy, but there was no practical substitute for the pressure insoles. The key to realizing accurate lumbar load estimates with this approach in the real world will be optimizing force estimates from pressure insoles. (4) Conclusions: Here, we present a promising wearable solution for the practical, automated, and accurate monitoring of low back loading during manual material handling.

Low back pain (LBP) is a common disorder that affects the working population worldwide. LBP causes more disability than any other conditions all around the world. Most existing studies focus on the occupational physical factors in association with LBP, while few focus on individual factors, especially the lack of quantitative calculation of waist comfort in biomechanics. Based on the physical statistics of Chinese men, this research used human posture analysis (HPA) to establish the waist strength formula and analyzed the waist strength during a manual material handling. It also explored the influence of weight and height of lifting objects on the L5-S1 spinal load. On this basis, a waist comfort model was proposed in combination with the recommended weight limit (RWL) recommended by NIOSH, and the parameter selection and waist comfort value were verified by Jack simulation software. The results show that pulling force of the Erector Spinae of the waist is closely related to the weight and lifting height of the object. Parameter verification and Jack software simulation results show that the force of L5-S1 is less than 3400 N, which proves that the waist force under this posture is acceptable. The developed waist comfort model can be applied to evaluate work risk, to adjust working intensity and powered exoskeleton design, aiming to decrease the prevalence of LBP.

Low back pain is a common occupational health issue especially among nurses that leads to suffering, disability and days of work lost that affect the continuity and quality of patients care. This study aims to determine prevalence of low back pain among registered nurse at Surgical Unit in RPZ II Hospital and identify the associated factors. It is a cross-sectional study that used a self-administered questionnaire to collect the data among a convenience sample of 60 nurses. Data was analyzed using Pearson Chi-Square. Majority of them were aged 31 to 40 years (53.3%), Malays (91.5%), married (84.6%), had working experience from 11 to 15 years(50.8%), had formal manual handling training(64.9%) and are overweight(58.3%). The prevalence of low back pain was 63.8%. The study revealed statistical significancea for race (p=0.002), number of patients they have to handle (p=0.005), satisfaction with working environment (p=0.007), and emotional and social problems (p=0.007, p=0.038, respectively).

Introduction: Low back pain is a common, recurrent and costly health problem worldwide. Nurses, particularly, are at higher risk than other health professionals to suffer from injuries and work related musculoskeletal disorders such as low back pain (LBP). Nurses injure their backs from the physical burden associated with manual handling of patients. Aim: The purpose of the study was to investigate the current working conditions of nurses with LBP in relation to their physical workload, and to depiction whether working prolonged shifts is associated with LBP. Method: Total 40 nurses with low back pain with high work load were included in the study. PSEQ was used to assess pain, ODI was used to assess disability, PSFS was used to assess functional activity. Data was analysed by using Pearson test. Result: Nurses were found to be having pain on self-efficacy for pain. On average their self-efficacy for pain was found to be moderate that is 38.78 with maximum score of 60. On average categorised themselves to have moderate disability with 27.83%. On average nurses were having moderate functioning affection with a mean total score of 6.1 when 3 major activities were considered. PSFS was found to be strongly correlated with PSEQ & moderately negative correlated with ODI and ODI was found to be moderately negatively correlated with pain and function scales. Conclusion: The nurses with existing low back pain with high work load has considerable self-efficacy for pain and their physical function and participation were moderately affected. Key words: Low back pain, oswestry disability index, Nurses

Disability has a substantial impact on a person's Quality of Life (QoL). Rehabilitation, a process where measures are taken to improve the QoL of people with disabilities, uses a variety of techniques. Community-based rehabilitation (CBR) is one such technique. It was developed in response to the region's serious QoL as well as its poor accessibility to and availability of rehabilitation services. Therefore, the main goal of this study was to address the concerns facing impaired children and to create a reliable intervention (CBR) for handling those problems. A quantitative research method was applied in this study. Data was collected from 256 participants who were with mild disability i.e., Hearing Impaired, Visually Impaired, Mentally Retarded and Physically Handicapped along with their immediate families, concerned trained volunteers from five different schools. In-depth research was conducted on them by using instrument i.e., World Health Organization Quality of Life (WHOQoL) Bref (WHO, 2004), The CBR model implemented in the community of Bahawalpur, Pakistan. The results of the study revealed satisfactory proof of CBR effectiveness. According to the study, a community-based integrated model of CBR that employs an educational strategy following the guidelines in the WHO CBR manual has positive associations with the enhancement of the QoL of disabled children and the caregivers who care for them. Implementations and future research suggestions are also discussed thoroughly.

ABSTRACT Based on observations of most of the workers at the LPG agent at Kelurahan Manggarai deploying gas cylinders manually for (± 8 hours) and the frequency of activities undertaken by workers is very high, based on interviews conducted by researchers found that most workers experience pain in the lower back. This can increase tension in the muscles and cause disability. This study aimed to determine the relationship between individual characteristics and occupational factors with complaints of low back pain in LPG agent workers at Kelurahan Manggarai Jakarta in 2020. This research was quantitative by using a cross-sectional design. The sampling technique was by total sampling where the number of samples was 52 people. Data were analyzed using the Chi-Square test. Workers' body positions were observed by adjusting the OWAS observation assessment sheet. The results of the analysis found that age, BMI, smoking habits, manual material handling and years of work have a significant relationship with LBP complaints (p-value <0.05), whereas physical activity does not have a significant relationship with LBP complaints (p-values >0.05). The company should create a two-wheeled hand truck based on worker anthropometry to minimize LBP complaints. ABSTRAK Berdasarkan hasil observasi sebagian besar pekerja pada agen LPG Kelurahan Manggarai Jakarta mengerahkan tabung gas secara manual selama kurang lebih 8 jam serta frekuensi aktivitas yang dilakukan pekerja sangat tinggi. Berdasarkan hasil wawancara yang dilakukan peneliti ditemukan sebagian besar pekerja mengalami LBP. Hal ini dapat meningkatkan ketegangan pada otot dan menimbulkan kecacatan. Penelitian ini bertujuan mengetahui hubungan karakteristik individu dan faktor pekerjaan dengan keluhan low back pain pada pekerja di agen LPG Kelurahan Manggarai Jakarta tahun 2020. Sebanyak 52 orang dilibatkan dalam penelitian ini dengan menggunakan teknik total sampling. Penelitian ini bersifat kuantitatif dengan menggunakan desain cross-sectional. Data dianalisis menggunakan uji Chi-Square. Posisi tubuh pekerja diamati dengan menyesuaikan lembar penilaian observasi OWAS. Hasil analisis menunjukan bahwa variabel usia, IMT, kebiasaan merokok, manual material handling, dan masa kerja memiliki hubungan yang bermakna dengan keluhan LBP (nilai-p <0,05), sedangkan aktivitas fisik tidak memiliki hubungan yang bermakna dengan keluhan LBP (nilai-p >0,05). Sebaiknya, perusahaan menciptakan hand truck dua roda yang dibuat berdasarkan antropometri pekerja agar meminimalisasi terjadinya keluhan LBP.

Objective: To describe the extent to which parents report that 4- to 17-year-olds with symptoms meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders need help, the types of help needed, the extent to which this need is being met and factors associated with a need for help. Method: During 2013–2014, a national household survey of the mental health of Australia’s young people (Young Minds Matter) was conducted, involving 6310 parents (and carers) of 4- to 17-year-olds. The survey identified 12-month mental disorders using the Diagnostic Interview Schedule for Children – Version IV ( n = 870) and asked parents about the need for four types of help – information, medication, counselling and life skills. Results: Parents of 79% of 4- to 17-year-olds with mental disorders reported that their child needed help, and of these, only 35% had their needs fully met. The greatest need for help was for those with major depressive disorder (95%) and conduct disorder (93%). Among these, 39% of those with major depressive disorder but only 19% of those with conduct disorder had their needs fully met. Counselling was the type of help most commonly identified as being needed (68%). In multivariate models, need for counselling was higher when children had autism or an intellectual disability, in blended families, when parents were distressed, and in the most advantaged socioeconomic areas. Conclusions: Many children and adolescents meeting Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria for mental disorders have a completely unmet need for help, especially those with conduct disorders. Even with mild disorders, lack of clinical assessment represents an important missed opportunity for early intervention and treatment.

Benign ureteroenteric anastomosis strictures (UESs) are one of many critical complications that may cause irreversible disability following robot-assisted radical cystectomy (RARC). Previous studies have shown that the incidence rates of UES after RARC can reach 25.3%, with RARC having higher UES incidence rates compared to open radical cystectomy. Various known and unknown factors are involved in the occurrence of UES. To minimize the incidence of UES after RARC, our group has standardized the procedure and technique for intracorporeal urinary diversion by applying the following five strategies: (1) wide delicate dissection of the ureter and preservation of the periureteral tissues; (2) gentle handling of the ureter and security of periureteral tissues at the anastomotic site; (3) use of indocyanine green to confirm good blood supply; (4) standardization of the ample ureteral spatulation length for Wallace ureteroenteric anastomosis through objective measurements; and (5) development of an institutional standardized procedure manual. This review focused on the incidence, etiology, prevention, and management of UES after RARC to bring attention to the incidence of this complication while also proposing standardized surgical procedures to minimize its incidence after RARC.

Background The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a widespread measure of disability and functional impairment, which is bundled with the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) for use in psychiatry. Administering psychometric scales via the Internet is an effective way to reach respondents and allow for convenient handling of data. Objective The aim was to study the psychometric properties of the 12-item self-report WHODAS 2.0 when administered online to individuals with anxiety and stress disorders. The WHODAS 2.0 was hypothesized to exhibit high internal consistency and be unidimensional. We also expected the WHODAS 2.0 to show high 2-week test-retest reliability, convergent validity (correlations approximately .50 to .90 with other self-report measures of functional impairment), that it would differentiate between patients with and without exhaustion disorder, and that it would respond to change in primary symptom domain. Methods We administered the 12-item self-report WHODAS 2.0 online to patients with anxiety and stress disorders (N=160) enrolled in clinical trials of cognitive behavior therapy, and analyzed psychometric properties within a classical test theory framework. Scores were compared with well-established symptom and disability measures, and sensitivity to change was studied from pretreatment to posttreatment assessment. Results The 12-item self-report WHODAS 2.0 showed high internal consistency (Cronbach alpha=.83-.92), high 2-week test-retest reliability (intraclass correlation coefficient=.83), adequate construct validity, and was sensitive to change. We found preliminary evidence for a three-factorial structure, but one strong factor accounted for a clear majority of the variance. Conclusions We conclude that the 12-item self-report WHODAS 2.0 is a psychometrically sound instrument when administered online to individuals with anxiety and stress disorders, but that it is probably fruitful to also report the three subfactors to facilitate comparisons between studies. Trial Registration Clinicaltrials.gov NCT02540317; https://clinicaltrials.gov/ct2/show/NCT02540317 (Archived by WebCite at http://www.webcitation.org/6vQEdYAem); Clinicaltrials.gov NCT02314065; https://clinicaltrials.gov/ct2/show/NCT02314065 (Archived by WebCite at http://www.webcitation.org/6vQEjlUU8)

: Lower back musculoskeletal disorders (MSDs) are an important public health problem and the leading cause of disability worldwide, but with yet unknown prevalence among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia-Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04–1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95% CI: 1.08–1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95% CI: 1.01–1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.

The management of health and safety requires employers to undertake risk assessments, identifying hazards in the workplace and the associated risks. They are then required to eliminate or reduce the level of risk to employees through the introduction of adequate control measures. Some health and safety legislation develops this aspect of assessment further, such as the Manual Handling Operations Regulations 1992 and the Health and Safety (Display Screen Equipment) Regulations 1992. The Disability Discrimination Act 1995 also places a number of duties on employers, some of which have an impact on health and safety. The Management of Health and Safety at Work Regulations 1992 requires employers to have access to competent advice to assist them to comply with the legislation. There are many people who can provide such advice: safety practitioners, occupational health nurses and physicians, occupational hygienists, physiotherapists and occupational therapists. The role of each practitioner needs to be appreciated by the employer and there should be systems in place that will allow referral within a reasonable timescale and contact between practitioners to work as a team. The benefits from having access to an occupational therapist can be demonstrated through the use of examples that highlight reduced costs to the employer from both reactive and proactive involvement. There are also a number of benefits to be gained by the employee.

Background Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID). Objective To evaluate whether or not such training is clinically effective in reducing challenging behaviour in routine care. The study also included longer-term follow-up (approximately 36 months). Design A multicentre, single-blind, two-arm, parallel-cluster randomised controlled trial. The unit of randomisation was the community ID service using an independent web-based randomisation system and random permuted blocks on a 1 : 1 allocation stratified by a staff-to-patient ratio for each cluster. Setting Community ID services in England. Participants Adults (aged > 18 years) across the range of ID with challenging behaviour [≥ 15 Aberrant Behaviour Checklist – Community total score (ABC-CT)]. Interventions Manual-assisted face-to-face PBS training to therapists and treatment as usual (TAU) compared with TAU only in the control arm. Main outcome measures Carer-reported changes in challenging behaviour as measured by the ABC-CT over 12 months. Secondary outcomes included psychopathology, community participation, family and paid carer burden, family carer psychopathology, costs of care and quality-adjusted life-years (QALYs). Data on main outcome, service use and health-related quality of life were collected for the 36-month follow-up. Results A total of 246 participants were recruited from 23 teams, of whom 109 were in the intervention arm (11 teams) and 137 were in the control arm (12 teams). The difference in ABC-CT between the intervention and control arms [mean difference –2.14, 95% confidence interval (CI) –8.79 to 4.51; p = 0.528] was not statistically significant. No treatment effects were found for any of the secondary outcomes. The mean cost per participant in the intervention arm was £1201. Over 12 months, there was a difference in QALYs of 0.076 in favour of the intervention (95% CI 0.011 to 0.140 QALYs) and a 60% chance that the intervention is cost-effective compared with TAU from a health and social care cost perspective at the threshold of £20,000 per QALY gained. Twenty-nine participants experienced 45 serious adverse events (intervention arm, n = 19; control arm, n = 26). PBS plans were available for 33 participants. An independent assessment of the quality of these plans found that all were less than optimal. Forty-six qualitative interviews were conducted with service users, family carers, paid carers and service managers as part of the process evaluation. Service users reported that they had learned to manage difficult situations and had gained new skills, and carers reported a positive relationship with therapists. At 36 months’ follow-up (n = 184), the mean ABC-CT difference between arms was not significant (–3.70, 95% CI –9.25 to 1.85; p = 0.191). The initial cost-effectiveness of the intervention dissipated over time. Limitations The main limitations were low treatment fidelity and reach of the intervention. Conclusions Findings from the main study and the naturalistic follow-up suggest that staff training in PBS as delivered in this study is insufficient to achieve significant clinical gains beyond TAU in community ID services. Although there is an indication that training in PBS is potentially cost-effective, this is not maintained in the longer term. There is increased scope to develop new approaches to challenging behaviour as well as optimising the delivery of PBS in routine clinical practice. Trial registration This study is registered as NCT01680276. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 15. See the NIHR Journals Library website for further project information.

Background: Workers in informal sector such as loading and unloading workers have a risk of experiencing health disorder of occupational disease such as musculoskeletloadingal disorders (MSDs). Such complain usually occurs on spine (back and neck) and upper limb. Most of the loading and unloading workers work using manual material handling, such as loading, unloading, pushing, pulling, throwing, moving, or rotating loads using their hands or other body parts. Such work method has musculoskeletal disorders (MSDs) risk, including low back pain. There are several factors causing the musculoskeletal disorders (MSDs) including individual factors (age and gender), work factors (workload and work posture), and work environment factors. Objective: The purpose of this study was to determine the direct and indirect effects of age and workload with work posture as an intervening variable against musculoskeletal disorders (MSDs) on loading and unloading workers at PT. Pelabuhan Indonesia IV (Persero) of Makassar Branch. Methods: The current research applied analytical observation with a Cross-Sectional approach involving 140 respondents selected through a simple random sampling technique. This research was further carried out at Pelabuhan Indonesia IV (Persero) of Makassar Branch in April-May 2021. Data obtained were analyzed using univariate, bivariate, and multivariate analysis. Results: There were 65 respondents (46.4%) who suffered from musculoskeletal disorder complaints in the high category followed by 53 respondents (37.9%) who suffered from musculoskeletal complaints in the very high category. It was also obtained that workload significantly affected the work position variable (p = 0.000 <0.05), age significantly affected the work posture variable (p = 0.000 <0.05), workload significantly affected the musculoskeletal disorders variable (p = 0.000 <0.05), and work posture significantly affected the musculoskeletal disorder variable (p = 0.000 <0.05). Conclusion: A significant indirect effect between workload and musculoskeletal disorders complaints through work posture variables. Significant indirect effect was also found between age and musculoskeletal disorder complaints through work posture. In addition, the highest category of low back pain complaints is in moderate disability.

Purpose This paper aims to underline the importance of using a collaborative approach when designing and adapting a post diagnostic psychosocial intervention of cognitive stimulation therapy (CST) for people with intellectual disability and dementia. Design/methodology/approach As part of a service improvement, a manual of CST was adapted, for delivery in clinical practice. A qualitative co-production method allowed participants with a lived experience to provide regular feedback relating to the development of the adapted CST manual and intervention programme. This feedback was used to make continual development changes to the CST manual. Findings The study demonstrated co-production with those who provide care is valuable in adapting psychosocial therapies for people with an intellectual disability and dementia. Additional findings identified the need for carer education in ageing, dementia care and the physical health needs for older people with intellectual disability. Originality/value To the best of the authors’ knowledge, this is the first study that has used a co-production approach with families and carers in adapting a group therapy programme for people with an intellectual disability. This paper underlines the need for post diagnostic clinical interventions for people with dementia and those who provide care.

Introduction Identify the factors that affect the risks and the adoption of risk control measures during the care of bariatric (morbidly obese) patients by paramedics and fire fighter first responders in Australia. Methods Focus groups were conducted in neutral locations in two Australian state capitals; a suburban region of Melbourne which straddled the rural and metropolitan boundaries; and a large regional Victorian town. Results Carers of bariatric patients are exposed to manual handling injury risk throughout the journey that bariatric patients take within the healthcare and funeral systems. In focussing on paramedics and fire service first responders, as key groups within that journey, it was found that the risks are significant but are not quantifiable. The injury risk is influenced by the nature and design of the range of environments within which patient movement is undertaken; the limited range of handling equipment available for use with bariatric patients; and the efficacy of organisational procedures and training. Adoption of risk controls is hampered by the absence of a standard definition of the term "bariatric" and gaps in the information flow during the bariatric patient journey through the health care system. Various definitions of bariatric are applied in different sectors and there are limitations to the use of both weight and body mass index in those definitions. Conclusion There is a lack of knowledge about how to safely manage the unique needs of bariatric patients. It appears that few streamlined systems have been established for patient management, and many cases are managed as if they are an isolated experience. There is little documentation of systems or case studies and thus very little sharing of the knowledge. Improvements in manual handling risk control for carers requires greater inter and intra-industry collaboration, which in turn requires an agreed definition of "bariatric".

Introduction: Nowadays, most industries in Iran constitute a large proportion of workers' activities in Manual Material Handling. Musculoskeletal disorders are areas of erosive and inflammatory conditions that occur in the form of pain and discomfort in the muscles, tendons, ligaments, joints, peripheral nerves, blood vessels. Working hours, absenteeism, increasing work restrictions, job changes and disability and impose many economic consequences on the individual, organization, and society. Materials and Methods: The present study was conducted to review the studies of Manual Material Handling by different methods in Iran from 2010 to 2020. The general process of the present study included searching for articles invalid national and international databases. After selecting the articles, the necessary information was extracted and analyzed. In general, based on the inclusion criteria, only studies that used NIOSH, KIM, SNOOK, 3DSSPP, WISHA, UTAH, MAC, ART, and manual handling regulations in Iran, were reviewed. Results: 15 English articles and 50 Persian articles were found, of which 44 articles were deleted based on the exclusion criteria, and 21 articles were selected for this study and entered into the final analysis. Conclusion: The highest number of studies was conducted in Hamedan, Tehran, Mallard, Shiraz, and Qazvin, respectively NIOSH, KIM and 3DSSPP were the three methods used with the highest number of studies in the field of Manual Material Handling in industry. Most workplace studies were conducted in the casting, food industry, tile industry, and hospital.

This paper accounts for a study of the joint ambitions of the Swedish Public employment office and social enterprises to integrate jobseekers with impairments in the labor market. The number of jobseekers with impairments has increased in western labor markets. The Swedish labor market is a particular case in point. Why? I use critical disability studies in combination with Marxist studies on immaterial labor to develop the following answer: An increasing number of jobseekers are diagnosed as impaired, not because their bodily constitution makes them unfit to handle manual labor, but because their socio-cultural characteristics make them unfit to handle immaterial forms of labor. Furthermore, I show how the diagnosis of these jobseekers as impaired does not lead to that they are also considered disabled. On the contrary, they are considered to have a particular, bio-medically defined fit and ability when it comes to handling simple, manual and low paid forms of work. Hereby, I argue that they are made up as a bio-medically defined “lumpenproletariat”.

Musculoskeletal disorders (MSDs) are common health problem throughout the world and a major cause of disability in the workplace. This study was conducted among workers of a small scale forging Industries. The small scale forging units involve various kinds of high repetitive processes like Blanking, cutting, shearing, furnace loading, hammering, punching and trimming etc. the workers performing these type of activities are suffering from various MSDs. In this study I had surveyed 10 small scales forging industries and randomly selected 102 workers among these industries. The most common ergonomics problems were found in industry like wrong working positions of the workers and manual material handling. MSDs are found due to Inappropriate and poor working postures, lack of task variation, poor ergonomic design of work places, poor design of plant layout, long working hours, low salaries and awkward schedules are all areas where relatively simple intervention can Significantly reduce the rate of exposure to MSDs.

Musculoskeletal disorders (MSDs) are common health problem throughout the world and a major cause of disability in the workplace. This study was conducted among workers of a small scale forging Industries. The small scale forging units involve various kinds of high repetitive processes like Blanking, cutting, shearing, furnace loading, hammering, punching and trimming etc. the workers performing these type of activities are suffering from various MSDs. In this study I had surveyed 10 small scales forging industries and randomly selected 102 workers among these industries. The most common ergonomics problems were found in industry like wrong working positions of the workers and manual material handling. MSDs are found due to Inappropriate and poor working postures, lack of task variation, poor ergonomic design of work places, poor design of plant layout, long working hours, low salaries and awkward schedules are all areas where relatively simple intervention can Significantly reduce the rate of exposure to MSDs.

Introduction: Cervicobrachial Pain Syndrome (CBPS) is a disorder of enhanced mechanosensitivity to the neural structure, also known as lower cervical pain Syndrome. Cervicobrachial pain is managed by manual and traditional therapy, besides medical management. Aim: The aim of this scoping analysis was to determine the efficacy of the protocols for cervicobrachial syndrome treatment. Materials and Methods: Until March 2020, initial literature searches were performed through robust online electronic databases such as “Scopus” “MEDLINE via PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Sciences and Cochrane Controlled Trials Register in Cochrane Library, Physiotherapy Evidence Database (PEDro), ProQuest 5000 International, ProQuest Health and Medical Complete, and following keywords were used “Neck Disability Index, “Upper Limb Tension test, “Goniometry “Neck pain,” “Cervicobrachial Pain Syndrome,” Thirty six studies were included in this scoping study using PRISMA guidelines. Results: There is little evidence of manual and conventional physiotherapy treatment of cervicobrachial pain and its efficacy. Key advantages have been reported in manual therapy and exercises methods for pain relief and rehabilitation. Electrotherapeutic modalities, neck strengthening exercises, traction and methods for handling soft tissue are considered to be less effective in managing cervicobrachial pain syndrome relative to manual therapy. Lateral cervical glide and median nerve slider technique (neurodynamic) have useful effects as a treatment intervention in multiple cases of cervicobrachial pain syndrome, such as the median nerve slider technique and contra-lateral cervical glide technique. Recommendations for the management of cervicobrachial syndrome in practice should be encouraged in additional trials of innovative treatment methods. Conclusion: Studies should identify which cervicobrachial pain respond to specific interventions for immediate and effective response so as to increase the quality of life of the patients. Further research with innovative techniques of therapeutic approach would facilitate practice guidelines for the management of cervicobrachial syndrome.

Impairments in dexterous upper limb function are a significant cause of disability following stroke. While the physiological basis of movement deficits consequent to a lesion in the pyramidal tract is well demonstrated, specific mechanisms contributing to optimal recovery are less apparent. Various upper limb interventions (motor learning methods, neurostimulation techniques, robotics, virtual reality, and serious games) are associated with improvements in motor performance, but many patients continue to experience significant limitations with object handling in everyday activities. Exactly how we go about consolidating adaptive motor behaviors through the rehabilitation process thus remains a considerable challenge. An important part of this problem is the ability to successfully distinguish the extent to which a given gesture is determined by the neuromotor impairment and that which is determined by a compensatory mechanism. This question is particularly complicated in tasks involving manual dexterity where prehensile movements are contingent upon the task (individual digit movement, grasping, and manipulation…) and its objective (placing, two step actions…), as well as personal factors (motivation, acquired skills, and life habits…) and contextual cues related to the environment (presence of tools or assistive devices…). Presently, there remains a lack of integrative studies which differentiate processes related to structural changes associated with the neurological lesion and those related to behavioral change in response to situational constraints. In this text, we shall question the link between impairments, motor strategies and individual performance in object handling tasks. This scoping review will be based on clinical studies, and discussed in relation to more general findings about hand and upper limb function (manipulation of objects, tool use in daily life activity). We shall discuss how further quantitative studies on human manipulation in ecological contexts may provide greater insight into compensatory motor behavior in patients with a neurological impairment of dexterous upper-limb function.

IntroductionIn a 2013 press release issued by Blind Citizens Australia, the advocacy group announced they were lodging a human rights complaint against the Australian government and the ABC over the lack of audio description available on the public broadcaster. Audio description is a track of narration included between the lines of dialogue which describes important visual elements of a television show, movie or performance. Audio description is broadly recognised as an essential feature to make television accessible to audiences who are blind or vision impaired (Utray et al.). Indeed, Blind Citizens Australia maintained that audio description was as important as captioning on Australian television:people who are blind have waited too long and are frustrated that audio description on television remains indefinitely beyond our reach. Our Deaf or hearing impaired peers have always seen great commitment from the ABC, but we continue to feel like second class citizens.While audio description as a technology was developed in the 1960s—around the same time as captions (Ellis, “Netflix Closed Captions”)—it is not as widely available on television and access is therefore often considered to be out of reach for this group. As a further comparison, in Australia, while the provision of captions was mandated in the Broadcasting Services Act (BSA) 1992 and television sets had clear Australian standards regarding their capability to display captions, there is no legislation for audio description and no consistency regarding the ability of television sets sold in Australia to display them (Ellis, “Television’s Transition”). While as a technology, audio description is as old as captioning it is not as widely available on television. This is despite the promise of technological advancements to facilitate its availability. For example, Cronin and King predicted that technological change such as the introduction of stereo sound on television would facilitate a more widespread availability of audio description; however, this has not eventuated. Similarly, in the lead up to the transition from analogue to digital broadcasting in Australia, government policy documents predicted a more widespread availability of audio description as a result of increased bandwidth available via digital television (Ellis, “Television’s Transition”). While these predictions paved way for an audio description trial, there has been no amendment to the BSA to mandate its provision.Audio description has been experienced on Australian broadcast television in 2012, but only for a 14-week trial on ABC1. The trial report, and feedback from disability groups, identified several technical impediments and limitations which effected the experience of audio described content during this trial, including: the timing of the trial during a period in which the transition from analogue to digital television was still occurring (creating hardware compatibility issues for some consumers); the limitations of the “ad hoc” approach undertaken by the ABC and manual implementation of audio description; and the need for upgraded digital receivers (ABC “Trial of Audio Description”, 2). While advocacy groups acknowledged the technical complexities involved, the expected stakeholder discussions that were due to be held post-trial, in part to attempt to resolve the issues experienced, were never undertaken. As a result of the lack of subsequent commitments to providing audio description, in 2013 advocacy group Blind Citizens Australia lodged their formal complaints of disability discrimination against the ABC and the Federal Government. Since the 2012 trial on ABC1, the ABC’s catch-up portal iView instigated another audio description trial in 2015. Through the iView trial it was further confirmed that audio description held considerable benefits for people with a vision impairment. They also demonstrated that audio description was technically feasible, with far less ‘technical difficulties’ than the experience of the 2012 broadcast-based trial. Over the 15 month trial on ABC iView 1,305 hours of audio described content was provided and played 158, 277 times across multiple platforms, including iOS, Android, the Freeview app and desktop computers (ABC, “ABC iView Audio Description Trial”).Yet despite repeated audio description trials and the lodgement of discrimination complaints, there remains no audio description on Australian broadcast television. Similarly, whereas 55 per cent of DVDs released in Australia have captions, only 25 per cent include an audio description track (Media Access Australia). At the time of writing, the only audio description available on Australian television is on Netflix Australia, a subscription video on demand provider.This article seeks to highlight the importance of television access for people with disability, with a specific focus on the provision of audio description for people with vision impairments. Research consistently shows that despite being a visual medium, people with vision impairments watch television at least once a day (Cronin and King; Ellis, “Netflix Closed Captions”). However, while television access has been a priority for advocates for people who are Deaf and hard of hearing (Downey), audiences advocating audio description are only recently making gains (Ellis, “Netflix Closed Captions”; Ellis and Kent). These gains are frequently attributed to technological change, particularly the digitisation of television and the introduction of subscription video on demand where users access television content online and are not constrained by broadcast schedules. This transformation of how we access television is also considered in the article, again with a focus on the provision–or lack thereof—of audio description.This article also reports findings of research conducted with Australians with disabilities accessing the emerging video on demand environment in 2016. The survey was run online from January to February 2016. Survey respondents included people with disability, their families, and carers, and were sourced through disability organisations and community groups as well as via disability-focused social media. A total of 145 people completed the survey and 12 people participated in follow-up interviews. Insights were gained into both how people with disability are currently using video on demand and their anticipated usage of services. Of note is that most subscription video on demand services (Netflix Australia, Stan, and Presto) had only been introduced in Australia in the year before the survey being carried out, with only Foxtel Play and Quickflix having been in operation for some time prior to that.Finally, the article ends by looking at past and current advocacy in this area, including a discussion on existing—albeit, to date, limited—political will.Access to Television for People with DisabilitiesTelevision can be disabling in different ways for people with impairments, yet several accessibility features exist to translate information. For example, people who are D/deaf or hard of hearing may require captions, while people with vision impairments prefer to make use of audio description (Alper et al.). Similarly, people with mobility and dexterity impairments found the transition to digital broadcasting difficult, particularly with relation to set top box set up (Carmichael et al.). As Joshua Robare has highlighted, even legislation has generally favoured the inclusion of audiences with hearing impairments, while disregarding those with vision impairments. Similarly, much of the literature in this area focuses on the provision of captions—a vital accessibility feature for people who are D/deaf or hard of hearing. Consequently, research into accessibility to television for a diversity of impairments, going beyond hearing impairments, remains deficient.In a study of Australian audiences with disability conducted between September and November 2013—during the final months of the analogue to digital simulcast period of Australian broadcast television—closed captions, clean audio, and large/colour-coded remote control keys emerged as the most desired access features (see Ellis, “Digital Television Flexibility”). Audio description barely registered in the top five. In a different study conducted two years ago/later, when disabled Australian audiences of video on demand were asked the same question, captions continued to dominate at 63.4 per cent; however, audio description was also seen to be a necessary feature for almost one third of respondents (see Ellis et al., Accessing Subcription Video).Robert Kingett, founder of the Accessible Netflix Project, participated in our research and told us in an interview that video on demand providers treat accessibility as an “afterthought”, particularly for blind people whom most don’t think of as watching television. Yet research dating back to the 1990s shows almost 100 per cent of people with vision impairments watch television at least once a day (Cronin & King). Statistically, the number of Australians who identify as blind or vision impaired is not insignificant. Vision Australia estimates that over 357,000 Australians have a vision impairment, while one in five Australians have a disability of some form. With an ageing population, this number is expected to grow exponentially in the next ten years (Australian Network on Disability). Kingett therefore describes this lack of accessibility as evidence video on demand is “stuck in the dark ages”, and advocates that people with vision impairments do use video on demand and therefore continue to have unmet access needs.Video on Demand—Transforming TelevisionSubscription video on demand services have caused a major shift in the way television is used and consumed in Australia. Prior to 2015, there was a small subscription video on demand industry in this country. However, in 2015, following the launch of Netflix Australia, Stan, and Presto, Australia was described as having entered the “streaming wars” (Tucker) where consumers would benefit from the increased competition. As Netflix gained dominance in the video on demand market internationally, people with disability began to recognise the potential this service could have in transforming their access to television.For example, the growing availability of video on demand services continues to provide disruptive change to the way in which consumers enjoy information and entertainment. While traditional broadcast television has provided great opportunities for participation in news, events, and popular culture, both socially and in the workplace, the move towards video on demand services has seen a notable decline in traditional television viewing habits, with online continuing to increase at the expense of Australian free-to-air programming (C-Scott).For the general population, this always-on, always-available, and always-shareable nature of video on demand means that the experience is both convenient and instant. If a television show is of interest to friends and family, it can be quickly shared through popular social media with others, allowing everyone to join in the experience. For people with disability, the ability to both share and personalise the experience of television is critical to the popularity of video on demand services for this group. This gives them not only the same benefits as others but also ensures that people with disability are not unintentionally excluded from participation—it allows people with disability the choice as to whether or not to join in. However, exclusion from video on demand is a significant concern for people with disability due to the lack of accessibility features in popular subscription services. The lack of captions, audio description, and interfaces that do not comply with international Web accessibility standards are resulting in many people with disability being unable to fully participate in the preferred viewing platforms of family and friends.The impact of this expands beyond the consumption patterns of audiences, shifting the way the audience is defined and conceptualised. With an increasing distribution of audience attention to multiple channels, products, and services, the ability to, and strategies for, acquiring a large audience has changed (Napoli). As audience attention is distributed, it is broken up, into smaller, fragmented groups. The success, therefore, of a new provider may be to amass a large audience through the aggregation of smaller, niche audiences. This theory has significance for consumers who require audio description because they represent a viable target group. In this context, accessibility is reframed as a commercial opportunity rather than a cost (Ellis, “Netflix Closed Captions”).However, what this means for future provision of audio description in Australia is still unclear. Chris Mikul from Media Access Australia, author of Access on Demand, was interviewed as part of this research. He told us that the complete lack of audio description on local video on demand services can be attributed to the lack of Australian legislation requiring it. In an interview as part of this research he explained the central issue with audio description in this country as “the lack of audio description on broadcast TV, which is shocking in a world context”.International providers fare only slightly better. Robert Kingett established the Accessible Netflix Project in 2013 with the stated aim of advocating for the provision of audio description on Netflix. Netflix, despite a lack of a clear accessibility policy, are seen as being in front in terms of overall accessibility—captions are available for most content. However, the provision of audio description was initially not considered to be of such importance, and Netflix were initially against the idea, citing technical difficulties. Nevertheless, in 2015—shortly after their Australian launch—they did eventually introduce audio description on original programming, describing the access feature as an option customers could choose, “just like choosing the soundtrack in a different language” (Wright). However, despite such successful trials, the issue in the Australian market remains the absence of legislation mandating the provision of audio description in Australia and the other video on demand providers have not introduced audio description to compete with Netflix. As the Netflix example illustrates, both legislation and recognition of people with disability as a key audience demographic will result in a more accessible television environment for this group.Currently, it is debatable as to whether this increasingly competitive market, the shifting perception of audience attraction and retention, and the entry of multiple international video on demand providers, has influenced how accessibility is viewed, both for broadcast television and video on demand. Although there is some evidence for an increasing consideration of people with disability as “valid” consumers—take, for example, the iView audio description trial, or the inclusion of audio description by Netflix—our research indicates accessibility is still inconsistently considered, designed for, and applied by current providers.Survey Response: Key Issues Regarding AccessibilityRespondents were asked to provide an overall impression of video on demand services, and to tell us about their positive and negative experiences. Analysis of 68 extended responses, and the responses provided by the interview participants, identified a lack of availability of accessibility features such as audio description as a key problem. What our results indicate is that while customers with a disability are largely accommodating of the inaccessibility of providers—they use their own assistive technology to access content—they are keenly aware of the provisions that could be made. As one respondent put it:they could do a lot better: talking menus, spoken sub titles, and also spoken messages on screen.However, many expressed low expectations due to the continued absence of audio description on broadcast television:so, the other thing is, my expectations are quite low because of years of not having audio descriptions. I have slightly different expectations to other people.This reflection is important in considering both the shifting expectations regarding video on demand providers but also the need for a clear communication of what features are available so that providers can cater to—and therefore capture—niche markets.The survey identified captioning as the main accessibility problem of video on demand services. However, this may not accurately reflect the need for other accessibility features such as audio description. Rather, it may be indicative that this feature is often the only choice given to consumers. As, Chris Mikul identified, “the only disability being catered for to any great extent is deafness/hearing impairment”. Kingett agreed, noting:people who are deaf and hard of hearing are placed way before the rest because captions are beyond easy and cheap to create now. Please, there’s even companies that people use to crowd source captions so companies don’t have to do it anymore. This all came about because the deaf community has [banded] together … to achieve a cause. I know audio description isn’t as cheap to make as captions but, by these companies’ budgets that’s like dropping a penny.Advocacy and Political WillAs noted above, it has been argued by some that accessibility features that address vision impairments have been neglected. The reason behind this is twofold—the perception that this disability is experienced by a minority of the population and that, because blind people “don’t watch television”, it is not an important accessibility feature. This points towards a need for both disability advocacy and political will by politicians to introduce legislation. As one survey respondent identified, the reality is that, in Australia, neither politicians nor people with vision impairments have yet to address the issue on audio description in an organised or sustained way:we have very little audio described content available in Australia. We don’t have the population of blind people nor the political will by politicians to force providers to provide for us.However, Blind Citizens Australia—the coalition of television audiences with vision impairments who lodged the human rights complaint against the government and the ABC—suggest the tide is turning. Whereas advocates for people with vision impairments have traditionally focused on access to the workforce, the issue of television accessibility is increasingly gaining attention, particularly as a result of international activist efforts and the move towards video on demand (see Ellis and Kent).For example, Kingett’s Accessible Netflix Project in the US is considered one of the most successful accessibility movements towards the introduction of audio description. While its members are predominantly US-based, it does include several Australian members and continues to cover Netflix Australia’s stance on audio description, and be covered by Australian media and organisations (including Media Access Australia and Life Hacker). When Netflix launched in Australia, Kingett encouraged Australians to become more involved in the project (Ellis and Kent).However, despite the progress towards mandating of audio description in parliament and the resolution of efforts made by advocacy groups (including Vision Australia and Blind Citizens Australia), the status of audio description remains uncertain. Whilst some support has been gained—specifically through motions made by Senator Siewert and the ABC iView audio description trials—significant change has been slow. For example, conciliation discussions are still ongoing regarding the now four-year-old complaint brought against the ABC and the Federal Government by Blind Citizens Australia. Meanwhile, although the Senate supported Senator Siewert’s motion to change the Broadcasting Services Act to include audio description, the Act has yet to be amended.The results of multiple ABC trials of audio description remain in discussion. Whilst the recently released report on the findings of the April 2015—July 2016 iView trial states that the “trial has identified that those who utilised the audio description service found it a valuable enhancement to their media engagement and their social interactions” (ABC, “ABC iView Audio Description Trial” 18), it also cautioned that “any move to introduce AD services in Australia would have budgetary implications for the broadcasters in a constrained financial environment” and “broader legislative implications” (ABC, “ABC iView Audio Description Trial” 18). Indeed, although the trial was considered “successful”—in that experiences by users were generally positive and the benefits considerable (Media Access Australia, “New Report”)—the continuation of audio description on iView alone was clarified as representing “a systemic failure to provide people who are blind or have low vision with basic access to television now, given that iView is out of reach for many people in the blindness and low vision community” (Media Access Australia, “New Report”). Indeed, the relatively low numbers of plays of audio described content during the trial (158, 277 plays, representing 0.58% of total program plays on iView) were likely a result of a lack of access to smartphones or Internet technology, prohibitive data speeds and/or general Internet costs, all factors which affect the accessibility of video on demand significantly more for people with disability (Ellis et al., “Access for Everyone?”).On a more positive note, the culmination of advocacy pressure, the ABC iView trial, political attention, and increasing academic literature on the accessibility of Australian media has resulted in the establishment of an Audio Description Working Group by the government. This group consists of industry representatives, advocacy group representatives, academics, and “consumer representatives”. The aims of the group are to: identify options to sustainably increase access to audio description services; identify any impediments to the implementation of audio description; provide expert advice on audio description implementation options; and develop a report on the findings due at the end of 2017.ConclusionIn the absence of audio description, people who are blind or vision impaired report a less satisfying television experience (Cronin and King; Kingett). However, with each technological advancement in the delivery of television, from stereo sound to digital television, this group has held hopes for a more accessible experience. The reality, however, has been a continued lack of audio description, particularly in broadcast television.Several commentators have compared the provision of audio description with closed captioning. They find that audio description is not as widely available, and reflect this is likely a result of lack of legislation (Robare; Ellis, “Digital Television Flexibility”)—for example, in the Australian context, whereas the provision of captions is mandated in the Broadcasting Services Act 1992, audio description is not. As a result, there have been limited trials of audio description in this country and inconsistent standards in how to display it. As discussed throughout this paper, people with vision impairments and their allies therefore often draw on the example of the widespread “acceptance” of captions to make the case that audio description should also be more widely available.However, following the introduction of subscription video on demand in Australia, and particularly Netflix, the issue of audio description is receiving greater attention. It has been argued that video on demand has transformed television, particularly the ways in which television is accessed. Video on demand could also potentially transform the way we think about accessibility for audiences with disability. While captions are a well-established accessibility feature facilitating television access for people with a range of disabilities, video on demand is raising the profile of the importance of audio description for audiences with vision impairments.ReferencesABC. “Audio Description Trial on ABC Television: Report to the Minister for Broadband, Communications and the Digital Economy”. Dec. 2012. 8 Apr. 2017 <https://www.communications.gov.au/sites/g/files/net301/f/ABC-Audio-Description-Trial-Report2.pdf>.ABC. “ABC iView Audio Description Trial: Final Report to The Department of Communications and the Arts.” Oct. 2016. 6 Apr. 2017 <https://www.communications.gov.au/documents/final-report-trial-audio-description-abc-iview>.Alper, Meryl, et al. “Reimagining the Good Life with Disability: Communication, New Technology, and Humane Connections.” Communication and the Good Life. 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