BackgroundThe World Health Organisation recommends that services accompany wheelchair distribution. This study examined the relationship of wheelchair service provision in Kenya and the Philippines and wheelchair-use–related outcomes.MethodWe surveyed 852 adult basic manual wheelchair users. Participants who had received services and those who had not were sought in equal numbers from wheelchair-distribution entities. Outcomes assessed were daily wheelchair use, falls, unassisted outdoor use and performance of activities of daily living (ADL). Descriptive, bivariate and multivariable regression model results are presented.ResultsConditions that led to the need for a basic wheelchair were mainly spinal cord injury, polio/post-polio, and congenital conditions. Most Kenyans reported high daily wheelchair use (60%) and ADL performance (80%), while these practices were less frequent in the Philippine sample (42% and 74%, respectively). Having the wheelchair fit assessed while the user propelled the wheelchair was associated with greater odds of high ADL performance in Kenya (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.6, 5.1) and the Philippines (OR 2.8, 95% CI 1.8, 4.5). Wheelchair-related training was associated with high ADL performance in Kenya (OR 3.2, 95% CI 1.3, 8.4). In the Philippines, training was associated with greater odds of high versus no daily wheelchair use but also odds of serious versus no falls (OR 2.5, 95% CI 1.4, 4.5).ConclusionSelect services that were associated with some better wheelchair use outcomes and should be emphasised in service delivery. Service providers should be aware that increased mobility may lead to serious falls.
Background: Experts in medical invasive evaluations, like colonoscopy, could be exposed to ergonomic risks during their work. Little attention has been given to these spectrum of occupational health. Its aimed to analyze possible clinical problems related to upper limb of physicians who perform those exams. Methods: Cross-sectional study in a health service in Sao Paulo, Brazil. For evaluation of the workplace of the colonoscopist physician were applied two tools: Couto´s check list and Sue Rodgers Method. The results direct the potential risk to upper limb injuries. Results: The procedure is done and the final report is issued. There are no mandatory pauses during workday. The dominant hand holds the tube insertion with pincer movement during the exam, digital prehension being necessary at times. For this activity the employee has to use some strength. Couto´s check list indicates a significant biomechanical factor. Sue Rodgers´s Method states high ergonomic risk for dominant hand/wrist/fingers. Conclusion: The main risk for the development of health disorders are associated with the use of force and repetitive movements of hands. The adoption of regular breaks to recover most of the structures required is recommended.
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