Displaying publications 3301 - 3320 of 5757 in total

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  1. Konadu KA, Anderson JS, Huang MB, Ali SA, Powell MD, Villinger F, et al.
    J AIDS Clin Res, 2015 Jul;6(7).
    PMID: 26523240
    CD4(+) T cell depletion and immune activation are hallmarks of HIV infection. Despite extensive studies, the mechanisms underlying immune modulation remain elusive. HIV-1 Nef protein is secreted in exosomes from infected cells and is abundant in the plasma of HIV+ individuals. Exosomal Nef (exNef) was also shown to induce apoptosis in bystander CD4(+) T cells. We hypothesized that exNef contributes to HIV pathogenesis. A HIV-1 NL4-3 virus containing alanine substitutions in the secretion modification region (SMR; amino acids 66 to 70; HIVNefsmr5a) was developed. Nef protein containing this modified SMR was shown to be deficient in exNef secretion in nef-transfected cells. Using both HIV-1 NL4-3 wild type (HIVwt) and HIVNefsmr5a, correlates of pathogenesis were evaluated in cell-lines, human peripheral blood mononuclear cells, and humanized NOD-RAG1(-/-) IL2r(-/-) double mutant (NRG) mice. Disruption of the SMR did not affect viral replication or exNef secretion from infected cell cultures as compared with nef-transfected cells. However, T cell apoptosis was reduced in HIVNefsmr5a infected cell cultures and CD4(+) T cell depletion was reduced in the spleen and peripheral blood of similarly infected NRG mice. Inflammatory cytokine release was also decreased in the sera of HIVNefsmr5a infected mice relative to HIVwt infected controls. These findings demonstrate the importance of Nef and the SMR motif in HIV pathogenesis and suggest a potential role for exNef in HIV-driven immune modulation.
  2. Akhtari-Zavare M, Latiff LA, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2015;16(15):6231-5.
    PMID: 26434821
    BACKGROUND: In Malaysia, breast cancer is the first cancer among females regardness of race.

    AIM: The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia.

    MATERIALS AND METHODS: This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice.

    RESULTS: The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for doing BSE (p<0.05).

    CONCLUSIONS: Our findings showed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysian females. A public health education program is essential to improve breast cancer prevention among this group.
  3. Mollah MM, Jamal R, Mokhtar NM, Harun R, Mollah MN
    PLoS One, 2015;10(9):e0138810.
    PMID: 26413858 DOI: 10.1371/journal.pone.0138810
    Identifying genes that are differentially expressed (DE) between two or more conditions with multiple patterns of expression is one of the primary objectives of gene expression data analysis. Several statistical approaches, including one-way analysis of variance (ANOVA), are used to identify DE genes. However, most of these methods provide misleading results for two or more conditions with multiple patterns of expression in the presence of outlying genes. In this paper, an attempt is made to develop a hybrid one-way ANOVA approach that unifies the robustness and efficiency of estimation using the minimum β-divergence method to overcome some problems that arise in the existing robust methods for both small- and large-sample cases with multiple patterns of expression.
  4. Othman MB, Khan A, Ahmad Z, Zakaria MR, Ullah F, Akil HM
    Carbohydr Polym, 2016 Jan 20;136:1182-93.
    PMID: 26572461 DOI: 10.1016/j.carbpol.2015.10.034
    This study attempted to clarify the influence of a cross-linker, N,N-methylenebisacrylamide (MBA), and N-isopropylacrylamide (NIPAM) on the non-isothermal kinetic degradation, solid state and lifetime of hydrogels using the Flynn-Wall-Ozawa (F-W-O), Kissinger, and Coats-Redfern (C-Red) methods. The series of dual-responsive Cs-PNIPAM-MBA microgels were synthesized by soapless-emulsion free radical copolymerization in an aqueous medium at 70 °C. The thermal properties were investigated using thermogravimetric analysis (TG) and differential scanning calorimetry (DSC) under nitrogen atmosphere. The apparent activation energy using the chosen Flynn-Wall-Ozawa and Kissinger methods showed that they fitted each other. Meanwhile, the type of solid state mechanism was determined using the Coats-Redfern method proposed for F1 (pure Cs) and F2 (Cs-PNIPAM-MBA hydrogel series) types, which comprise random nucleation with one nucleus reacting on individual particles, and random nucleation with two nuclei reacting on individual particles, respectively. On average, a higher Ea was attributed to the greater cross-linking density of the Cs hydrogel.
  5. Khalil MI, Ahmmed I, Ahmed R, Tanvir EM, Afroz R, Paul S, et al.
    Biomed Res Int, 2015;2015:624159.
    PMID: 26539517 DOI: 10.1155/2015/624159
    We investigated the protective role of Withania somnifera leaf extract (WSLEt) on isoproterenol- (ISO-) induced myocardial infarction (MI) in rats. Subcutaneous injection of ISO (85 mg/kg body weight (b.w.)) administered to rats for two consecutive days caused a significant increase in cardiac troponin I (cTnI) levels and serum lipid profiles, as well as the activities of some marker enzymes. In addition to these diagnostic markers, there were increased levels of lipid peroxidation (LPO) and decreased activities of enzymatic antioxidants (superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GRx), and glutathione-S-transferase (GST)) in the myocardium. However, oral pretreatment (100 mg/kg b.w.) with WSLEt for 4 weeks elicited a significant cardioprotective activity by lowering the levels of cTnI, lipid profiles, and marker enzymes. The levels of LPO products were also significantly decreased. Elevated activities of antioxidant enzymes were also observed in rats pretreated with WSLEt. As further confirmed histopathologically, our findings strongly suggest that the cardioprotective effect of WSLEt on myocardium experiencing ISO-induced oxidative damage may be due to an augmentation of the endogenous antioxidant system and an inhibition of LPO in the myocardial membrane. We conclude that WSLEt confers some protection against oxidative damage in ISO-induced MI in rats.
  6. Lau P, Bidin N, Krishnan G, AnaybBaleg SM, Sum MB, Bakhtiar H, et al.
    PMID: 26313856 DOI: 10.1016/j.jphotobiol.2015.08.009
    The photobiostimulation effects of near infrared 808 nm diode laser irradiance on diabetic wound were investigated. 120 rats were induced with diabetes by streptozotocin injection. Full thickness punch wounds of 6mm diameter were created on the dorsal part of the rats. All rats were randomly distributed into four groups; one group served as control group, whereas three groups were stimulated daily with unchanged energy density dose of 5 J/cm(2) with different power density, which were 0.1 W/cm(2), 0.2 W/cm(2) and 0.3 W/cm(2) with different exposure duration of 50s, 25s and 17s, respectively. Ten rats from each group were sacrificed on day 3, 6 and 9, respectively. Skin tissues were removed for histological purpose. The contraction of wound was found optimized after exposure with 0.1 W/cm(2). Based on the histological evidence, laser therapy has shown able to promote wound repair through enhanced epithelialization and collagen fiber synthesis. Generally, irradiated groups were advanced in terms of healing than non-irradiated group.
  7. Nguyen HT, Dawal SZ, Nukman Y, Rifai AP, Aoyama H
    PLoS One, 2016;11(4):e0153222.
    PMID: 27070543 DOI: 10.1371/journal.pone.0153222
    The conveyor system plays a vital role in improving the performance of flexible manufacturing cells (FMCs). The conveyor selection problem involves the evaluation of a set of potential alternatives based on qualitative and quantitative criteria. This paper presents an integrated multi-criteria decision making (MCDM) model of a fuzzy AHP (analytic hierarchy process) and fuzzy ARAS (additive ratio assessment) for conveyor evaluation and selection. In this model, linguistic terms represented as triangular fuzzy numbers are used to quantify experts' uncertain assessments of alternatives with respect to the criteria. The fuzzy set is then integrated into the AHP to determine the weights of the criteria. Finally, a fuzzy ARAS is used to calculate the weights of the alternatives. To demonstrate the effectiveness of the proposed model, a case study is performed of a practical example, and the results obtained demonstrate practical potential for the implementation of FMCs.
  8. Looi LJ, Aris AZ, Haris H, Yusoff FM, Hashim Z
    Chemosphere, 2016 Jun;152:265-73.
    PMID: 26974481 DOI: 10.1016/j.chemosphere.2016.02.126
    The present study examined the concentrations of mercury (Hg), methylmercury (MeHg), and selenium (Se) in the multiple tissues of the Plotosus canius and Periophthalmodon schlosseri collected from the Strait of Malacca. The mean value in mg kg(-1) of Hg (P. canius: 0.34 ± 0.19; P. schlosseri: 0.32 ± 0.18) and MeHg in muscle (P. canius: 0.14 ± 0.11; P. schlosseri: 0.17 ± 0.11) were below the Codex general standard for contaminants and toxins in food and feed (CODEX STAN 193-1995), the Malaysian Food Regulation 1985 and the Japan Food Sanitation Law. For P. canius, the liver contained the highest concentrations of Hg (0.48 ± 0.07 mg kg(-1)) and MeHg (0.21 ± 0.00 mg kg(-1)), whereas for P. schlosseri, the gill contained the highest concentrations of Hg (0.36 ± 0.06 mg kg(-1)) and MeHg (0.21 ± 0.05 mg kg(-1)). The highest concentration of (80)Se (mg kg(-1)) was observed in the liver of P. canius (20.34 ± 5.68) and in the gastrointestinal tract (3.18 ± 0.42) of P. schlosseri. The selenium:mercury (Se:Hg) molar ratios were above 1 and the positive selenium health benefit value (HBVSe) suggesting the possible protective effects of Se against Hg toxicity. The estimate weekly intakes (EWIs) in μg kg(-1) body weight (bw) week(-1) of Hg (P. canius: 0.27; P. schlosseri: 0.15) and MeHg (P. canius: 0.11; P. schlosseri: 0.08) were found to be lower than the provisional tolerable weekly intake established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Based on the calculated EWIs, P. canius, and P. schlosseri were found to be unlikely to cause mercury toxicity in human consumption.
  9. Singh SK, Yahya N, Misiran K, Masdar A, Nor NM, Yee LC
    Rev Bras Anestesiol, 2016 May-Jun;66(3):259-64.
    PMID: 26993410 DOI: 10.1016/j.bjan.2014.09.009
    Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.
  10. Nkem BM, Halimoon N, Yusoff FM, Johari WLW, Zakaria MP, Medipally SR, et al.
    Mar Pollut Bull, 2016 Jun 15;107(1):261-268.
    PMID: 27085593 DOI: 10.1016/j.marpolbul.2016.03.060
    In this study, we isolated two indigenous hydrocarbon-degrading bacteria from tarball found in Rhu Sepuluh beach, Terengganu, Malaysia. These bacteria were identified based on their physiological characteristic and 16S rRNA gene sequence analysis, and they showed 99% similarity with Cellulosimicrobium cellulans DSM 43879 and Acinetobacter baumannii ATCC 19606 respectively. Their hydrocarbon-degrading capabilities were tested using diesel-oil as sole carbon source. Results analysed using GC-MS, showed diesel-oil alkanes were degraded an average 64.4% by C. cellulans and 58.1% by A. baumannii with medium optical density reaching 0.967 (C. cellulans) and 1.515 (A. baumannii) in minimal salt media at 32°C for 10days. Individual diesel-oil alkanes were degraded between 10%-95.4% by C. cellulans and 0.2%-95.9% by A. baumannii. Both strains utilized diesel-oil for growth. The study suggests both strains are part of indigenous hydrocarbon-degrading bacteria in tarball with potential for bioremediation of oil-polluted marine environment.
  11. Mohd Azman NA, Gallego MG, Segovia F, Abdullah S, Shaarani SM, Almajano Pablos MP
    PMID: 27043639 DOI: 10.3390/antiox5020011
    The common bearberry (Arctostaphylos uva-ursi L. Sprengel) is a ubiquitous procumbent evergreen shrub located throughout North America, Asia, and Europe. The fruits are almost tasteless but the plant contains a high concentration of active ingredients. The antioxidant activity of bearberry leaf extract in the 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS) radical cation assay was 90.42 mmol Trolox equivalents/g dry weight (DW). The scavenging ability of the methanol extract of bearberry leaves against methoxy radicals generated in the Fenton reaction was measured via electron paramagnetic resonance. Lipid oxidation was retarded in an oil-water emulsion by adding 1 g/kg lyophilised bearberry leaf extract. Also, 1 g/kg of lyophilised bearberry leaf extract incorporated into a gelatin-based film displayed high antioxidant activity to retard the degradation of lipids in muscle foods. The present results indicate the potential of bearberry leaf extract for use as a natural food antioxidant.
  12. Qureshi MA, Noor RM, Shamim A, Shamshirband S, Raymond Choo KK
    PLoS One, 2016;11(3):e0152727.
    PMID: 27031989 DOI: 10.1371/journal.pone.0152727
    Radio propagation models (RPMs) are generally employed in Vehicular Ad Hoc Networks (VANETs) to predict path loss in multiple operating environments (e.g. modern road infrastructure such as flyovers, underpasses and road tunnels). For example, different RPMs have been developed to predict propagation behaviour in road tunnels. However, most existing RPMs for road tunnels are computationally complex and are based on field measurements in frequency band not suitable for VANET deployment. Furthermore, in tunnel applications, consequences of moving radio obstacles, such as large buses and delivery trucks, are generally not considered in existing RPMs. This paper proposes a computationally inexpensive RPM with minimal set of parameters to predict path loss in an acceptable range for road tunnels. The proposed RPM utilizes geometric properties of the tunnel, such as height and width along with the distance between sender and receiver, to predict the path loss. The proposed RPM also considers the additional attenuation caused by the moving radio obstacles in road tunnels, while requiring a negligible overhead in terms of computational complexity. To demonstrate the utility of our proposed RPM, we conduct a comparative summary and evaluate its performance. Specifically, an extensive data gathering campaign is carried out in order to evaluate the proposed RPM. The field measurements use the 5 GHz frequency band, which is suitable for vehicular communication. The results demonstrate that a close match exists between the predicted values and measured values of path loss. In particular, an average accuracy of 94% is found with R2 = 0.86.
  13. Thakur S, Singh L, Wahid ZA, Siddiqui MF, Atnaw SM, Din MF
    Environ Monit Assess, 2016 Apr;188(4):206.
    PMID: 26940329 DOI: 10.1007/s10661-016-5211-9
    Increasing heavy metal (HM) concentrations in the soil have become a significant problem in the modern industrialized world due to several anthropogenic activities. Heavy metals (HMs) are non-biodegradable and have long biological half lives; thus, once entered in food chain, their concentrations keep on increasing through biomagnification. The increased concentrations of heavy metals ultimately pose threat on human life also. The one captivating solution for this problem is to use green plants for HM removal from soil and render it harmless and reusable. Although this green technology called phytoremediation has many advantages over conventional methods of HM removal from soils, there are also many challenges that need to be addressed before making this technique practically feasible and useful on a large scale. In this review, we discuss the mechanisms of HM uptake, transport, and plant tolerance mechanisms to cope with increased HM concentrations. This review article also comprehensively discusses the advantages, major challenges, and future perspectives of phytoremediation of heavy metals from the soil.
  14. Saidykhan L, Abu Bakar MZ, Rukayadi Y, Kura AU, Latifah SY
    Int J Nanomedicine, 2016;11:661-73.
    PMID: 26929622 DOI: 10.2147/IJN.S95885
    A local antibiotic delivery system (LADS) with biodegradable drug vehicles is recognized as the most effective therapeutic approach for the treatment of osteomyelitis. However, the design of a biodegradable LADS with high therapeutic efficacy is too costly and demanding. In this research, a low-cost, facile method was used to design vancomycin-loaded aragonite nanoparticles (VANPs) with the aim of understanding its potency in developing a nanoantibiotic bone implant for the treatment of osteomyelitis. The aragonite nanoparticles (ANPs) were synthesized from cockle shells by a hydrothermal approach using a zwitterionic surfactant. VANPs were prepared using antibiotic ratios of several nanoparticles, and the formulation (1:4) with the highest drug-loading efficiency (54.05%) was used for physicochemical, in vitro drug release, and biological evaluation. Physiochemical characterization of VANP was performed by using transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray powder diffraction, and Zetasizer. No significant differences were observed between VANP and ANP in terms of size and morphology as both samples were cubic shaped with sizes of approximately 35 nm. The Fourier transform infrared spectroscopy of VANP indicated a weak noncovalent interaction between ANP and vancomycin, while the zeta potential values were slightly increased from -19.4±3.3 to -21.2±5.7 mV after vancomycin loading. VANP displayed 120 hours (5 days) release profile of vancomycin that exhibited high antibacterial effect against methicillin-resistant Staphylococcus aureus ATCC 29213. The cell proliferation assay showed 80% cell viability of human fetal osteoblast cell line 1.19 treated with the highest concentration of VANP (250 µg/mL), indicating good biocompatibility of VANP. In summary, VANP is a potential formulation for the development of an LADS against osteomyelitis with optimal antibacterial efficacy, good bone resorbability, and biocompatibility.
  15. Aziz ZA, Lee YY, Sidek NN, Ngah BA, Looi I, Hanip MR, et al.
    Neurol Res, 2016 May;38(5):406-13.
    PMID: 27142804 DOI: 10.1080/01616412.2016.1178948
    Gender as an independent predictor in stroke has been well documented. However, data on gender differences among first-ever ischemic stroke in developing country are limited. We aim to describe gender effects on clinical characteristics, thrombolysis treatment received, and outcomes of patients with first-ever ischemic stroke.
  16. Kabir MZ, Mukarram AK, Mohamad SB, Alias Z, Tayyab S
    J. Photochem. Photobiol. B, Biol., 2016 Jul;160:229-39.
    PMID: 27128364 DOI: 10.1016/j.jphotobiol.2016.04.005
    Interaction of a promising anticancer drug, lapatinib (LAP) with the major transport protein in human blood circulation, human serum albumin (HSA) was investigated using fluorescence and circular dichroism (CD) spectroscopy as well as molecular docking analysis. LAP-HSA complex formation was evident from the involvement of static quenching mechanism, as revealed by the fluorescence quenching data analysis. The binding constant, Ka value in the range of 1.49-1.01×10(5)M(-1), obtained at three different temperatures was suggestive of the intermediate binding affinity between LAP and HSA. Thermodynamic analysis of the binding data (∆H=-9.75kJmol(-1) and ∆S=+65.21Jmol(-1)K(-1)) suggested involvement of both hydrophobic interactions and hydrogen bonding in LAP-HSA interaction, which were in line with the molecular docking results. LAP binding to HSA led to the secondary and the tertiary structural alterations in the protein as evident from the far-UV and the near-UV CD spectral analysis, respectively. Microenvironmental perturbation around Trp and Tyr residues in HSA upon LAP binding was confirmed from the three-dimensional fluorescence spectral results. LAP binding to HSA improved the thermal stability of the protein. LAP was found to bind preferentially to the site III in subdomain IB on HSA, as probed by the competitive drug displacement results and supported by the molecular docking results. The effect of metal ions on the binding constant between LAP and HSA was also investigated and the results showed a decrease in the binding constant in the presence of these metal ions.
  17. Alif Adlan MT, Wan Mohd Rasis WA, Mohd Ramadhan MD
    Med J Malaysia, 2016 04;71(2):72-3.
    PMID: 27326946 MyJurnal
    Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen. At surgery, she was found to have abscess at the posterior psoas muscle where she underwent open surgery drainage and percutaneous drain was inserted. A high index of suspicion of iliopsoas abscess should be maintained among haemodialysis patients presenting with intradialytic pelvic and hip pain and treated with optimal antibiotics therapy with appropriate surgical intervention.
  18. Marziah Z, Mahdzir A, Musa MN, Jaafar AB, Azhim A, Hara H
    Microbiologyopen, 2016 12;5(6):967-978.
    PMID: 27256005 DOI: 10.1002/mbo3.380
    This study for the first time provides insight into the bacterial community in the benthic region of the Off-Terengganu Coastline, which is considered to be anthropogenically polluted due to heavy fishing vessel commotion. Subsurface bacteria were randomly collected from two locations at different depths and were examined using the 16S rDNA V3-V4 marker gene on the Illumina™ Miseq platform. In addition, the physiochemical parameters of the sediment were also measured. Surprisingly, the results show a high diversity of sulfur-oxidizing bacteria in the surveyed area, where Sulfurovum sp. was identified to predominate the overall bacterial community. The physiochemical parameters reveal insufficient evidence of hydrothermal vents in the surveyed area. However, there are traces of hydrocarbon pollutants such as gasoline, diesel, and mineral oil in this area. It is assumed that sediment accumulation in the lee of breakwater plays an important role in trapping the runoff from the nearby harbor, which includes oil spills. Based on the common knowledge, Sulvurofum sp. is a native bacterium that exists in deep hydrothermal vents and volcanic territories. Although the reason for the abundance of Sulfurovum sp. in the surveyed area is still unclear, there is a possibility that metabolic adaptation plays an important role in regulating hydrocarbon pollutants for survival. The work presented in this paper therefore has profound implications for future studies on Sulfurovum sp. versatility. However, future research is needed to strengthen the findings of this study and to provide a better evidence regarding the metabolic response of this bacterium toward hydrocarbon pollutants.
  19. Masum AK, Azad MA, Hoque KE, Beh LS, Wanke P, Arslan Ö
    PeerJ, 2016;4:e1896.
    PMID: 27168960 DOI: 10.7717/peerj.1896
    The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses' demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses' job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses' job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service.
  20. Sukadarin EH, Deros BM, Ghani JA, Mohd Nawi NS, Ismail AR
    Int J Occup Saf Ergon, 2016 Sep;22(3):389-98.
    PMID: 27173135 DOI: 10.1080/10803548.2016.1156924
    INTRODUCTION: This review describes standardized ergonomics assessment based on pen-and-paper observational methods for assessing ergonomics risk factors.

    OBJECTIVE: The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects.

    METHODOLOGY: The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects.

    RESULTS: The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures.

    CONCLUSION: Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems.

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