Half of Enterprises Use Web 2.0 Media Technologies

Half of Enterprises Use Web 2.0 Media Technologies | Engagement: a one-hit wonder, or long-term keeper?

Helge: We've discussed the use of Web 2.0 technologies to promote Mediracer and to get into a dialog with CTS professionals and clients. What are the pro's and con's? Does improved communication and web presence lead to new contacts with new customers in the specified market areas?

54 percent of enterprises use Web 2.0 technologies, as do 74 percent of companies with fewer than 500 employees, according to a study Web 2.0 technology adoption and the future of social-media initiatives in enterprises, reports MarketingCharts.

Helge: Smaller companies are more flexible and adapt new technologies faster. Mediracer is an innovative point of care diagnostic devices company and fits well into the first in line user groups.


Among the highlights of the study, "Trends in Adopting Web 2.0 for the Enterprise in 2007," released by Awareness (via FASTforward):

• Blogs are the most-used Web 2.0 technology (87 percent of respondents), followed by communities, wikis, RSS feeds and social networking.
  Helge: Mediracer started with blogs: English, Swedish and Finnish. Social Networking might be useful in project management and for CRM / Intranet applications. Mediracer has adapted a net based CRM.
  
  
• The most successful are blogs (44 percent of respondents), communities (42 percent) and wikis (39 percent).
  Helge: Blogs are a good starting point.
  
  
  
• 96 percent say all Web 2.0 technologies they've used have been successful; 83 percent reporting no clear failures.
  Helge: We still need to improve the traffic to be sure about the value. No problems with the initial implementation. Traffic and focusing concerns are still in the background.
  
  
• The greatest obstacle to Web 2.0 deployment is limited internal resources.
  Helge: Blogging has been outsourced.
  
  
• Some 64 percent of those using Web 2.0 technologies rely on a combination of internal- and external-facing media/tools.
  Helge: Blogs are external and CRM is internal.
  

Among the benefits of external-facing social media, according to the study:

• Increased customer engagement: 68 percent Helge: We would like to see people commenting more. The dialog aspect is still lacking.
  
  
• Increased brand awareness & loyalty: 64 percent Helge: I hope the brand awareness has improved. The blog readership has risen from 10 to 20 per day up to 50 and over 100 readers per day. We already had 111 readers today from 89 places for the En, Se, Fi blogs.
  
  
• Effective market research: 58 percent Helge: I think we've have a good reaction from all the key market areas. The "reader maps" are showing a continuous flow of new readers.
  

Among the benefits of internal-facing social-media technologies, according to the study:

• Improved communication, collaboration: 91 percent Helge: Communication yes, collaboration still to show up.
  
  
• Locating experts within the company: 81 percent Helge: Hopefully locating experts around the world willing to work with Mediracer.
  
  
• Improving knowledge management: 78 percent Helge: I would like to say yes, but there is much to do in this respect in the future.
  

"The Awareness research found that … 28 percent of organizations with over 500 employees have budgets greater than $50,000 for web 2.0 tools or social media. The top tools planned are blogs and wikis (56 percent) but many are also planning to deploy online communities," writes FASTforward's Bill Ives.

Helge: We speak bout a much smaller budget and do only apply one of the tools in the Web 2.0 toolbox.

A new service model for CTS diagnostics and treatment

Carpal Tunnel Syndrome is a work related illness. We're looking into a new service model. Would it be possible to locate occupational health diagnostic units at frequented shopping centers? How about private mobile clinics visiting industries and office complexes to screen CTS patients at an early stage?

First I have to take a closer look at how NHS operates in UK and relate it to private services available.

Residents of the UK and certain others, defined by complicated rules, have free access to all medical services delivered by the UK National Health Service - usually called the NHS. Visitors may have access to some of these services too, but rules put in place to prevent health tourism - arriving in the UK for free medical treatment -- mean visitors to the UK still need travelers' health insurance.

I need to learn more about the way NHS operates in UK. Below valuable information for visitors in UK.

Only emergency treatment is free:

If you have an accident or need emergency medical treatment, you will receive that treatment free of charge, regardless of your nationality or place of residence as long as that emergency treatment is delivered at:

• A primary care facility or GP's office
• A hospital emergency room
• A walk-in center providing services similar to an emergency room.

Once you are admitted to a hospital - even for emergency surgery or further emergency treatment - you have to pay for your treatment and medicines.

If you are asked to return for a clinic visit follow up after your emergency treatment, you will also have to pay for that.

Other services that are free to all:
Visitors also have free access to:

• Treatment for some infectious diseases
• Compulsory psychiatric treatment
• Family planning services.

Are the rules the same for all visitors?:

No. Some visitors to the UK have more access to the NHS than others:

• Visitors from EU countries and other members of what is called the European Economic Area are subject to somewhat more access to the National Health Service.
• Visitors from countries which have a bilateral agreement with the UK may also have access to more services.
• People working in certain kinds of occupations - such NATO employees and some voluntary workers - may also have free access to the NHS.

For a full list of visitors who have free or partially free access to NHS services, check the NHS Website.

Carpal Tunnel Syndrome costs a lot of Money

Slide 1: COMPUTER ERGONOMICS • US. NAVAL HOSPITAL ROTA SPAIN • INDUSTRIAL HYGIENE DEPT. • Revised March 2006

Slide 2: COURSE OBJECTIVES • Understand the definition of ergonomics • Understand Primary Causes of Cumulative Trauma Disorders (CTDs). • Understand ways to prevent CTDs • Learn about PC workstation accessories to reduce computer work stress • Basic exercises to reduce / relieve ergo- stress.

Slide 3: DEFINITION • ERGONOMICS is a way to work smarter--not harder by designing of tools, equipment, work stations and tasks to fit the job to the worker--NOT the worker to the job: – Layout / type of controls & displays – Lighting & Temperature – Process (Heights, reaches, weights)

Slide 4: WHY WORRY ? • Work Related Musculoskeletal Disorders (WMSDs) declined from 784,100 to 582,300 annual lost workday cases from 1992 to 1997(OSHA) thanks to workplace ergonomic programs • Minimum $120 to 240 billion total costs / year & average $29 K / case compensation claim cost • More lost workdays for RSIs (ave. = 30 days for a Carpal Tunnel injury)

Slide 5: MSD INJURY DATA • ~600,000 MSDs require time off from work. • Older, out-of-shape workers much more vulnerable. • Women suffer more ergonomic injuries due: – to having jobs requiring more heavy lifting, repetitive tasks and awkward postures – 70% of Carpal Tunnel – 62% of Tendonitis

Slide 6: CAR COST IS (PARTIALLY)--A PAIN IN THE BACK !! • According to Dr. E.W. Simmons, president of the American Back Society, medical costs related to back injury can add up to $3000 to the price of every car made in Detroit !!

Slide 7: CTD INJURY FACTORS • Lesions to tendons of the neck, back, shoulders, arms, wrists or hands • Primary causes: – Repetitive movements over long periods of time – Awkward postures – Use of excessive forces

Slide 8: CTD RISK CONTROL: POSTURE • NEUTRAL & COMFORTABLE: – Wrists straight – Shoulders relaxed with elbows close to body – head / shoulders & back in vertical alignment – Frequent breaks when bent postures can’t be avoided

Slide 9: ERGONOMIC ALIGNMENT

Slide 10: CARPAL TUNNEL SYNDROME • Occurs with repetitive motion of hands & wrists--especially with high force levels. • Incidence up to 15% in certain industries. • A “natural” keyboard and good wrist support can help most PC users avoid problems • GOOD NEWS: Have dropped over 30% since 1992--which most attribute to strong workplace ergonomics programs

Slide 11: CTD RISK CONTROL: REPETITION • Use automatic tools for repetitive tasks (screw and bolt tightening) • Eliminate unnecessary tasks / movements by redesigning maintenance procedures and workstations • Take short, frequent breaks • Alternate tasks and processes to use different muscle groups

Slide 12: ERGONOMICS SUMMARY • Good ergonomic design of tools, processes and furniture DOES improve personnel comfort, health, morale, productivity and readiness. • Individual effort as part of a workshop team is the greatest means of identifying / improving workplace ergonomic issues. • It’s critical to seek prompt medical aid for symptoms of ergonomic stress / CTDs

Slide 13: Computer Ergonomics • Routine PC user defined as spending 20 hours or more per week working at a computer. • Studies of PC users have not shown a risk of eye damage...although fatigue very possible. • NIOSH studies have not indicated a radiation hazard nor pregnancy risk from PC usage. • Workers using bi/tri-focal glasses before beginning PC use may need special purpose glasses for computer work.

Slide 14: “NATURAL” KEYBOARDS • Three types: Fixed split, Adjustable split & “Sculptured” • Awkward wrist postures minimized with 15 to 25 horizontal degree key split AND 8 to 66 degree vertical incline. • Key Layout Design Changes Have: – increased comfort (81% of users) – improved postures – reduced muscle activity – lowered carpal tunnel pressure in lab settings • Unfortunately obtained oftentimes to alleviate an injury after-the-fact

Slide 15: WRIST RESTS • No medical evidence that they reduce RSI injuries...As they work for some, but not for others • Usage Guidelines: – Buy rest that is even with top of keyboard – Material should be “medium-soft” (foam--gel mix) so foam doesn’t break down. AVOID hard plastic types – DON’T leave wrists on rest...which compresses carpal tunnel. Palm rest instead. – Changing typing habits more critical than wrist support – MOST APPROPRIATELY USED TO REST HANDS DURING PAUSE IN TYPING • LEARN TO TYPE CORRECTLY WITH “FLOATING WRISTS” FIRST!!!

Slide 16: Ergonomic chairs • Adjustable back height • Adjustable arm rests • Required by OPNAV 5100 Safety Instruction • **Chair on left NOT ergonomically designed

Slide 17: Alternative Pointing Devices • Track-balls • “Scrolling” Mouse

Slide 18: Other Ergonomic PC Accessories • Height-adjustable articulating keyboard tray • **Basic units start at $20, and occasionally stocked in the NEX Depot or Sight & Sound stores for $19.99 !

Slide 19: UNSAT PC Work Station “Design”

Slide 20: UNSAT PC Work Station “Design”

Slide 21: MODEL COMPUTER WORKSTATION • --Keyboard trays WITH wrist support. • --Split \"Natural\" keyboards to facilitate neutral wrist angle • --Fully adjustable ergonomic chair • --Document holder to minimize head / eye & neck movements • --Corner desk units to position monitor directly in front of employee • --Foot rest where requested. • --Re-organization of

Slide 22: Questions ??... Contact Data • NAVHOSP Rota IH Dept. (x2783 / 2315) • Dave Hiipakka: email:dwhiipakka@rota.med.navy.mil • Kevin Dyrdahl (2315): ksdyrdahl@rota.med.navy.mil • COMNAVACTS Ergonomics Team: – ergoteam@navsta.rota.navy.mil

Hand disorders

Slide 1: Common Hand and Foot Disorders

Slide 2: Common hand problems

Slide 3: Function of the hand Motor grasp pinch - tip pressure - pulp pressure - lateral pressure hook

Slide 4: Function of hand sensory „ stereognosis (position ,size, shape,etc.) „ Pinprick „ light touch

Slide 5: Rapid assessment of hand function „ space and stability „ open and close „ pinch and touch

Slide 6: Muscles of the hand Three group of muscles act on the fingers „ long flexors „ long extensors „ intrinsic muscles

Slide 7: Ganglion cystic swelling in the neighbourhood of tendon or joint

Slide 8: Ganglion pathology wall „ lining „ content „ uni.. or multilocular cyst „

Slide 9: Ganglion formation „ large no. of closely packed cells „ formation of cavity „ mucoid degeneration ? ischemia

Slide 10: Ganglion site „ 60-70% dorsal wrist ganglion (scapholunate joint) „ 18 -20% volar ganglion „ 10 - 20% in the flexor sheath

Slide 11: Ganglion treatment „ conservative „ surgical

Slide 12: Carpal Tunnel Syndrome (CTS) The entrapment of the median nerve at the fibro osseous tunnel of the carpus.

Slide 13: CTS Aetiology Decrease in the size of the canal „ osteoarthritis „ trauma „ acromegaly

Slide 14: CTS Aetiology 2 increase in the size of its contents „ pregnancy „ rheumatoid arthritis „ alcoholism „ tumour „ idiopathic

Slide 15: CTS Clinical Picture patients in their 40s „ female > male „ pain (nocturnal) „ numbness „ clumsiness „

Slide 16: CTS signs wasting of thener eminence „ numbness „ weakness „ Tinnel sign „ Phalen sign „

Slide 17: CTS Treatment „ non operative splint steroid injection „ surgical decompression arthroscopic open

Slide 18: De Quervains Disease Stenosing tenovaginitis of the first dorsal extensor compartment

Slide 19: De Quervain’s Treatment „ non operative rest steroid injection anti-inflamatory „ operative

Slide 20: Trigger Fingers stenosing tenovaginitis of the flexor tendon sheath(A1 pulley)

Slide 21: Trigger Finger aetiology „ congenital (thumb) ‚ often not recognised until toddlers ‚ 30% resolve spontaneously „ acquired (middle aged) idiopathic ‚ traumatic ‚ diabetes ‚ rheumatoid ‚

Slide 22: Trigger Finger treatment „ non operative ‚ steroid injection „ operative ‚ release of A1 pulley

Slide 23: Dupuytren’s Contracture nodular hypertrophy and contracture of the palmar fascia

Slide 24: Dupuytren’s Contracture aetiology genetic „ geographical „ smoking „ alcohol „ epilepsy „

Slide 25: Dupuytren’s Contracture clinical middle aged „ male 10 x female „ nodular thickening in the palm „ contracture of the ring and little finger „ MCPJ and/or IPJ not DIPJ „

Slide 26: Dupuytren’s Contracture treatment Surgery if:- ‚ rapidly progressive contracture ‚ inconvenience „ fasciotomy „ fasciectomy „ amputation

Slide 27: Foot Disorders „ deformities „ arthritis „ pain

Slide 28: Deformities Pes Planus physiological „ congenital (vertical talus) „ joint hypermobility „ paralytic „ compensatory „ spasmodic (peroneal muscle spasm) „

Slide 29: Pes Planus Peroneal muscle spasm tarsal coalition ‚ infection ‚ inflammatory arthritis ‚ fractures ‚

Slide 30: Deformities Pes Cavus „ idiopathic „ neurological abnormality eg • spinal dysraphism • peroneal muscular atrophy • Friedrich’s ataxia

Slide 31: Deformities Hallux Valgus „ female > male „ adolescent (familial) „ middle aged

Slide 32: Hallux Valgus symptoms „ deformity „ pain pbunion o metatarsalgia nMT-P OA mhammer toe

Slide 33: Hallux Valgus treatment Soft tissue balancing „ distal osteotomy „ proximal osteotomy „ excision „ fusion „

Slide 34: Deformities Lesser toes curly toes „ claw toes (neurological) „ hammer toes „ mallet toes „ overlapping „

Slide 35: Lesser toe deformities treatment „ modify footwear „ tendon release / transfer „ excision „ arthrodesis

Slide 36: Osteoarthritis Hallux Rigidus „ male > female „ repeated trauma „ loss of dorsiflexion

Slide 37: Hallux Rigidus treatment rocker sole „ dorsal cheilectomy „ extension osteotomy „ arthrodesis „ excision „ replacement „

Slide 38: Rheumatoid arthritis hindfoot „ Ankle pain and swelling ‚ tenosynovitis ‚ ankle or sub-talar joint „ Ankle and tarsal joint erosion and deformity

Slide 39: Rheumatoid arthritis forefoot „ hallux valgus „ claw toes „ MT-P dislocation

Slide 40: Foot pain „ Mechanical pressure • foot-shoe mismatch joint inflammation „ bone lesion „ peripheral vascular disease „ muscle strain „

Slide 41: Heel pain Sever’s disease „ heel bumps „ peritendonitis „ plantar fasciitis „ • idiopathic • ankylosing spondylitis • Reiter’s disease • gonorrhoea

Slide 42: Midfoot pain „ Köhler’s disease „ tarsal boss „ osteoarthritis „ tarsal tunnel syndrome

Slide 43: Forefoot pain hallux valgus „ hammer toe „ Freiberg’s disease „ stress fracture „ Morton’s neuroma „

About Us - Carpal Tunnel Treatment Center

About Us - Carpal Tunnel Treatment Center: "Dr. Zev Cohen is a recognized leading expert in the field of repetitive strain injuries. He has been featured on over 100 radio and TV stations.

Julie Donnelly is a Deep Muscle Therapist with 14 years of experience specializing in the treatment of chronic joint pain and sports injuries. She works extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

Together they have pioneered an effective non-surgical treatment for carpal tunnel syndrome/wrist and hand pain. They have also co-authored a series of books that teach the Julstro Self-Treatment Techniques.

Dr. Cohen and Julie Donnelly have been widely published, both on- and off-line, in magazines, newsletters, and newspapers around the country. They have been chosen to speak at National Conventions, Medical Schools, and health facilities nationwide."

Helge: I'll be in touch with you about Mediracer in the near future.