A thesis submitted to the faculty of Health Sciences, University of Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy Johannesburg, 2017 / Background Work has long been suspected of being involved in the genesis of musculoskeletal disorders. These disorders have been found to affect a significant proportion of the working population. Certain occupational groups across different industries are at a particular risk of musculoskeletal disorders possibly, due to the nature of their work, including nurses and bank workers. In South Africa, there is a paucity of information regarding musculoskeletal disorder risk factors in these two occupational groups. Additionally, no follow-up studies have been conducted to examine incident (new onset) and persistent pain and socio-cultural factors potentially associated with musculoskeletal pain. The research reported in this thesis was conducted in public hospital nurses and call centre bank workers. Objectives  To determine the 12-month prevalences and body site localisation of reported musculoskeletal disorders in South African public hospital nurses and bank workers.  To characterise the features and consequences of prevalent musculoskeletal disorders in South African public hospital nurses and bank workers.  To identify the risk factors associated with prevalent musculoskeletal disorders in South African public hospital nurses and bank workers.  To determine incident and persistent musculoskeletal disorders in South African public hospital nurses.  To identify the risk factors associated with persistent musculoskeletal disorders in South African public hospital nurses. Methods The study had a baseline cross-sectional component which included both nurses and bank workers and a follow-up component ranging from 11.2-13.0 months from baseline which covered nurses. The main data collection tools were the modified CUPID baseline and follow-up questionnaires which were composites of standardised and validated instruments. Since the questionnaires were written in English, the baseline questionnaire was piloted in a suitable group of workers not earmarked for the study, for clarity and comprehension of questions and the time it would take to administer one questionnaire. After making the necessary changes, the baseline questionnaire was administered through interviews to 488 South African workers comprising 252 nurses and 236 bank workers who provided informed consent to participate in the study. Information about demographic characteristics, potential musculoskeletal disorder risk factors and occurrence of musculoskeletal disorders and their associated consequences was collected. At follow-up, 189 nurses (75.3%) who had participated at baseline were successfully re-interviewed about the occurrence of musculoskeletal disorders a month before the follow-up period. The collected data were cleaned and prepared for analysis. Descriptive statistics were generated followed by the selection of explanatory variables to be included in the multiple logistic regression. These variables were used to build partial models with age group, sex and occupational group. Variables with p-values ≤ 0.2 were viii selected for the full models. The full models were run to produce final models which contained variables with p-values < 0.05. Results Prevalence and characteristics of musculoskeletal disorders in South African workers, public hospital nurses, and bank workers The estimated 12-month prevalences (95% CI) of musculoskeletal disorders reported by the South African workers, public hospital nurses, and bank workers were high at 80.5% (77.0%-84.0%), 84.1% (79.5%-88.6%) and 76.7% (71.3%-82.1%), respectively. The most prevalent pain was in the low back (56.9%, 58.2% and 55.5%) and the least prevalent in the elbows (14.3%, 13.2% and 15 7%). More than half (58.6%, 64.9% and 51.4%) of the workers who reported pain in different body sites consulted healthcare providers for pain. Conservative estimates of sick leave days taken by each worker in the past 12 months due to musculoskeletal disorder pain were 2.2, 2.4 and 1.9 days for all workers, nurses and bank workers, respectively. Risk factors for musculoskeletal disorders in South African workers, public hospital nurses and bank workers Somatising tendency In South African workers, somatising tendency was associated with the reporting of pain in all body sites considered in the study. The associations with pain in “any” body site ORs (95% CI) 2.23 (1.15-4.31); 3.52 (1.84-6.72) and low back 1.81 (1.07-3.03); 2.72 (1.69-4.40), demonstrated increasing trends when the effect of one and two distressing somatic symptoms was compared to no symptoms, respectively. In public hospital nurses, it was associated with pain in four body sites which included “any” body site 6.58 (1.76-24.47) and knees 2.80 (1.33-5.86) and in bank workers, in six body sites which included “any” body site 3.17 (1.40-7.19) and low back 2.56 (1.22-5.36) when the effect of two or more distressing somatic symptoms was compared to no symptoms. Sex “Women” in South African workers and bank workers was associated with pain in the upper limbs constituted by shoulders 1.83 (1.04-3.37); 1.90 (1.01-3.59) and wrists or hands 2.28 (1.09-4.74); 2.53 (1.11-5.75) compared to men, respectively. Age group In South African workers, age groups (40-49 and ≥50 years) demonstrated increasing trends with pain in the shoulders 2.23 (1.27-3.90); 2.40 (1.21-4.79) and knees 2.18 (1.16-4.09); 2.50 (1.16-5.38), respectively. In public hospital nurses, age group (40-49 years) was associated with pain in the shoulders 4.70 (1.15-19.10) and age group (≥50 years) with pain in “any” body site 2.67 (1.09-6.54). In bank workers, an increasing trend with age groups (40-49 and ≥50 years) was demonstrated with pain in the knees 2.91 (1.19-7.10) and 4.04 (1.32-12.38), respectively. The effect of each age group was compared to <30 years age group. Occupational group Occupational group (bank workers) was associated with pain in the neck 1.66 (1.04-2.67) but no positive association was found with pain in “any” body site 0.51 (0.27-0.96) compared to nurses. Incident and persistent musculoskeletal disorders in public hospital nurses Incident “any” musculoskeletal disorders (95% CI) were estimated at 47.6% (36.5%-58.6%) with incident low back pain affecting the largest percentage of nurses (32.8%) and incident elbow pain (8.5%) the lowest. Persistent “any” musculoskeletal disorders (95% CI) were estimated at 83.7% (76.2%-91.1%) with persistent knee pain affecting most nurses (71.4%) and persistent elbow pain the least number of nurses (36.4%). Risk factor for persistent musculoskeletal disorders in public hospital nurses Somatising tendency was associated with persistent pain in “any" body site 7.32 (1.34-39.88) when the effect of two or more distressing somatic symptoms was compared to no symptoms. Ethnicity Ethnic group was associated with wrists or hands and low back. In all workers, Nguni and “other” ethnic groups were associated with wrists or hands 1.85 (1.08-3.18); 2.02 (1.09-3.72) and in bank workers 3.75 (1.41-9.97); 2.87 (1.13-7.28), respectively. In nurses, the “other” ethnic group was associated with wrists or hands 2.81 (1.07-7.39). In all workers, “other” ethnic group was associated with low back 1.86 (1.07-3.34) and in bank workers 2.43 (1.16-5.08). The effect of ethnic groups was compared to the Sotho group. Conclusions The study found a high burden of musculoskeletal disorders in the two groups of workers studied with pain in the low back being the most prevalent. The large proportions of workers, who consulted healthcare providers and took time off from work due to musculoskeletal disorders, indicate the negative impact that these disorders may have on the affected workers and their places of work. The main risk factors emerging from this research belong to the individual dimension of musculo-skeletal disorder risk factors. This may signal their importance in the development and persistence of these disorders. Furthermore, they may need to be considered in any effort to address musculoskeletal disorders in the groups of workers studied. This study failed to provide convincing evidence of association between ethnicity and musculoskeletal disorders in the groups studied. / MT2017

<p>Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL &ndash / BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs.</p>

<p>Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL &ndash / BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs.</p>

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2002. / Includes bibliographical references.

Thesis--Wisconsin. / Vita. Includes bibliographical references (leaves 348-356).

Osteoarthritis (OA) is a debilitating disease caused by the deterioration of articular cartilage and is a leading cause of disability in the United States and worldwide. Much current research into improved treatment for this disease is focused on tissue engineering through the growth of cartilage sheets made by articular chondrocytes. However, as chondrocytes proliferate in vitro, they also lose their ability to produce dense extracellular matrix, a necessary component of articular cartilage conferring mechanical strength. SOX9, a transcriptional activator, increases type II collagen expression, a key articular cartilage extracellular matrix component. Thus, SOX9 promotes an articular cartilage phenotype. Therefore, increasing SOX9 expression and activity as a transcriptional activator in culture has the potential to improve tissue engineering outcomes. This project serves to generate SOX9 promotor-driven secreted luciferase reporter chondrocytes to monitor chondrogenic properties temporally and non-destructively for use in high-throughput analysis of culturing conditions and drug screening.

Tsang Kwai Fan. / Thesis submitted in: December 2003. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (leaves 85-101). / Abstracts in English and Chinese. / Abstracts --- p.i / 摘要 --- p.iii / Acknowledgements --- p.v / Table of Abbreviations --- p.vi / Table of Contents --- p.vii / Chapter Chapter One: --- Introduction of Curcumin / Chapter 1.1 --- What is curcumin? --- p.1 / Chapter 1.2 --- Chemistry of curcumin --- p.2 / Chapter 1.3 --- History of using turmeric --- p.3 / Chapter 1.4 --- Curcumin in biological system --- p.4 / Chapter 1.5 --- Current researches on curcumin --- p.7 / Chapter 1.6 --- Curcumin Toxicity --- p.13 / Chapter Chapter Two: --- Introduction of Muscle Regeneration / Chapter 2.1 --- Reasons for studying muscle regeneration --- p.15 / Chapter 2.2 --- Skeletal muscle: functions and structure --- p.16 / Chapter 2.3 --- Muscle healing process --- p.17 / Chapter 2.4 --- Muscle formation --- p.31 / Chapter 2.5 --- Current trends in enhancing muscle regeneration --- p.37 / Chapter Chapter Three: --- Methodology / Chapter 3.1 --- Animals --- p.41 / Chapter 3.2 --- Histology --- p.42 / Chapter 3.3 --- Measurement of cross-sectional area of muscles --- p.42 / Chapter 3.4 --- Two-dimensional electrophoresis --- p.43 / Chapter 3.5 --- Protein identification by matrix-assisted laser desorption time-of-flight (MALDI-TOF) --- p.47 / Chapter 3.6 --- Cell culture --- p.50 / Chapter 3.7 --- In vitro cell proliferation assay / Chapter 3.8 --- In vitro differentiation assay --- p.51 / Chapter 3.9 --- Transfection and Secreted Alkaline Phosphatase (SEAP) reporter assay --- p.52 / Chapter Chapter Four: --- Results / Chapter 4.1 --- Effects of curcumin on muscle regeneration --- p.58 / Chapter 4.2 --- Two-dimensional electrophoresis --- p.59 / Chapter 4.3 --- Effect of curcumin on myogenic cell proliferation --- p.61 / Chapter 4.4 --- Effect of curcumin on myogenic cell differentiation --- p.61 / Chapter 4.5 --- Signal transduction --- p.63 / Chapter 4.6 --- Legends and table --- p.65 / Chapter Chapter Five: --- Discussion --- p.77 / Chapter Chapter Six: --- Conclusions --- p.84 / References --- p.85 / Appendices --- p.102

Neuromuscular junction (NMJ) dysfunction has been identified as one of the earliest events in Amyotrophic Lateral Sclerosis (ALS) pathology. However, which tissue type induces NMJ disruption; be it the motoneurons (hMN), Schwann cells or skeletal muscle (hSKM) remains unresolved. While mechanisms by which ALS hMN contribute to NMJ dysfunction are well-described in literature, limited information exist on how the other tissue types in the tripartite synapse (hSKM and Schwann cells) induce and/or contribute to ALS NMJ disruption. A fair understanding of the role of each tissue type in NMJ dysfunction would help shape the trajectory of future ALS research and drug discovery. It is generally accepted that the observed ALS hSKM weakness and atrophy are a result of hMN axonal retraction. While recent findings postulate the active pathologic involvement of the hSKM in ALS onset via NMJ disruption, some scientists have questioned the validity of the transgenic model used in most studies and the translatability of their results. Contrarily, in vitro modeling of this phenomenon using patient hSKM samples has proved challenging due to the inability to reliably expand and maintain them before becoming senescent. Thus, this study sought to investigate the pathology of hSKM derived from patient ALS (ALS hSKM), its possible contribution to NMJ dysfunction, and whether hSKM-specific treatment confer any therapeutic benefit to the NMJ. To avoid the main challenges associated with human-based ALS hSKM studies i.e., tissue scarcity and established culturing challenges, patient iPSCs were utilized as the tissue source. This assured a single source for obtaining both cell types necessary for modeling the ALS NMJ. IPSC-derived wild type (WT) and ALS hSKM were differentiated using a serum-free, small molecule-directed protocol which centered on the concurrent modulation of the Wnt and bone morphogenetic protein pathways. To determine whether the ALS hSKM has intrinsic deficits independent of hMN, comparative assessment of WT and ALS hSKM were carried out. The myogenicity of resultant WT and ALS progenitors were confirmed via phase-contrast microscopy, immunocytochemistry, and flow cytometry, after which they were terminally differentiated in myotubes. WT and ALS hSKM were compared morphologically and functionally. The inner mitochondrial membrane potential (ΔΨM) and metabolic plasticity of both WT and ALS hSKM were also evaluated. After the hSKM-only characterization, both ALS and WT hSKM were co-cultured with either ALS or WT hMNs. This was to study how the previously outlined hSKM deficits affect NMJ formation, integrity and function in an effort to delineate the sole contribution to NMJ disruption. With knowledge of the pathologic contribution to NMJ dysfunction, hSKM-specific Creatine treatments were performed to investigate its therapeutic benefit to the ALS NMJ. This project advances the field's knowledge on the hSKM's role to ALS NMJ disruption and creates awareness about considering the hSKM in future research and drug discovery exploits. Additionally, this project resulted in the development of microphysiological platforms that recapitulate known phenotypic parameters of ALS while allowing the independent treatment and/or interrogation of each tissue type in the co-cultures.

Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.

No description available.