The ANALISIS BEBAN KERJA OPERATOR PAPER MESIN #6 PT. INDAH KIAT PULP AND PAPER TBK MENGGUNAKAN METODE CARDIOVASCULAR LOAD (CVL) DAN SUBJECTIVE WORKLOAD ASSESSMENT TECHNIQUE ( SWAT )

Indah Kiat Pulp and Paper Tbk merupakan perusahaan industri manufaktur yang bergerak dibidang pengolahan bubur kertas, salah satu mesin kertas terbesar di Perawang adalah Paper mesin #6. Paper mesin #6 beroperasi secara kontinyu 24 jam dan untuk mendukung proses produksi tersebut jam kerja karyawan dibagi menjadi 3 shift kerja. Permasalahan yang terjadi pada paper mesin ini adalah tingginya angka kecelakaan kerja dikarenakan tingginya beban kerja yang dirasakan oleh operator sehingga menyebabkan operator kelelahan baik fisik maupun mental. Penelitian dilakukan pada operator stasiun produksi Wet End, Dry End, Chemical, Winder dan Thimons yaitu dilakukan pengukuran beban kerja fisik dengan menggunakan metode Cardiovascular Load (CVL) dan pengukuran beban kerja mental dengan metode Subjective Workload Assessment Technique (SWAT). Hasil perhitungan metode CVL bahwa beban kerja fisik yang paling besar pada shift 3 grup B terjadi pada operator Thimons 1 memiliki nilai % CVL sebesar 46,62 % dengan rekomendasi diperlukan perbaikan dan operator Wet End 3 dengan nilai % CVL sebesar 44,74 % dengan keterangan diperlukan perbaikan. Berdasarkan hasil CVL, sebanyak 12 karyawan mengalami beban kerja fisik. Berbeda dengan kepala shift dan operator Dekstop Control System (DCS), beban kerja yang dirasakan cenderung lebih ke beban mental. Penelitian pada kepala shift dan operator DCS menggunakan metode, metode SWAT digunakan untuk mengukur beban kerja mental. Penelitian dilakukan dengan cara pengamatan dan wawancara secara langsung, selanjutnya kepala shift dan operator DCS diminta untuk mengurutkan 27 lembar kartu SWAT yang terdiri dari Time Load(T), Mental Effort Load(E) dan Psycological Stress Load (S). hasil pengurutan kartu SWAT diolah dengan menggunakan aplikasi DosBox 0.74, setelah itu dilakukan pengkonversian nilai dari Time, Effort dan Stress (T.E.S). Berdasarkan perhitungan beban kerja mental kepala shift, faktor yang paling berpengaruh adalah faktor Time dengan nilai 60,44% diikuti faktor Effort dan Stress dengan nilai 29,64% dan 9,92%. Hal serupa dengan operator DCS, faktor yang paling berpengaruh adalah faktor Time dengan nilai 68,57% diikuti faktor Effort dan Stress dengan nilai 23,29% dan 8,13%. Beban waktu menjadi faktor utama yang dirasakan oleh karyawan karena tuntutan pekerjaan yang mengharuskan karyawan harus cepat dalam melakukan setiap aktivitas.

Cardiovascular Risks Before Myocardial Infarction Differences Between Men and Women

Background Prodromal cardiac symptoms are warning signals preceding cardiac disease. Previous studies have shown some gender differences in prodromal symptoms as well as established risk factors for MI. This study aims to map possible gender differences in social factors and established risk factors preceding myocardial infarction (MI). Methods The study includes data of N=213 middle-aged men and women, all diagnosed with myocardial infarction (ICD-10 I21.9) from the region of south-east Sweden. They answered a questionnaire at discharge from the cardiologic clinic and additional clinical data from medical records were merged from the National Swedeheart Register. Results The dominant prodromal symptom for both sexes were experience of chest pain at the onset of MI. The major gender differences were that significantly more females (p=0.015) had a hyperlipidemia diagnose. Females also reported to have experienced higher stress load the year preceding myocardial infarction with serious life events (p=0.019), strained economy (p=0.003), and reports of sadness/depression (p<0.001). Females reported higher perceived stress load than men (p=0.006). Men had higher systolic blood pressure than women at hospital admission and a higher systolic- and diastolic blood pressure at discharge. Conclusion Influences of the social environment, such as serious life events, strained economy, depression, stress, and sleep deprivation were stronger as potential risk factors for myocardial infarction in women than among men. Of the traditional risk factors only, hyperlipidemia was more frequent among women. These findings could contribute to a deeper understanding of diagnostic differences between gender, as well as a more gender-oriented cardiovascular preventive work.

739 Atypical presentation of Takotsubo syndrome early after pacemaker implantation

Aims Takotsubo syndrome (TTS) is an acute stress-induced cardiomyopathy showing left ventricular (LV) dysfunction without obstructive coronary arteries disease. A sudden massive surge of circulatory catecholamines from an intense physical or emotional stress may play a central role in the pathogenesis of TTS. We report the case of an 87 years-old woman who developed TTS with uncommon presentation after permanent pacemaker (PM) implantation. Methods and results The patient was referred to our hospital for PM implantation because of advanced atrio-ventricular block (3:1). She suffered by rheumatoid arthritis (RA), arterial hypertension, and chronic kidney disease. Echocardiogram, performed before PM implantation, showed normal LV kinesis and normal ejection fraction (EF 60%). She was initially administered with infusion of Isoprenaline 2 mcg/min. The subsequent day, she underwent permanent dual-chamber pacemaker implantation without any complications. After 3 days, the patient complained severe asthenia and fever, together with increase of white blood cells and C reactive protein. Blood cultures were negative. We started antibiotic therapy and, suspecting a reactivation of RA, steroid therapy with infusion of methylprednisolone 40 mg/die. Electrocardiogram showed normal sinus rhythm and paced ventricular rhythm. PM interrogation showed normal function. Surprisingly, echocardiogram showed LV dysfunction with apical and medium segments akinesia, and severe EF reduction (35%). Coronary angiography documented absence of coronary obstructive lesions, assessing diagnosis of TTS. The patient was discharged 1 week after admission in good clinical condition. One week later, an echocardiogram showed apical akinesia, partial recovery of medium segments motility, and slight increase of EF (40%). The excess of catecholamines could lead to decreased cardiac muscular function and to spasm of coronary arteries: these events can lead to acute heart failure and decrease of LVEF. Furthermore, about 90% of patients with TTS are women, especially in postmenopausal period. Peculiarities of this case were the atypical symptoms of TTS and the combination of different predisposing stressors factors: female sex in postmenopausal period, anamnesis of chronic inflammatory disease, use of stress-inducing drugs (methylprednisolone and isoprenaline, the last associated with TTS after PM-implantation), atrio-ventricular block itself, and PM implantation procedure. Our findings remark that even a low-risk procedure could be a possible cause of TTS in patient with such risk factors. In our opinion, in this subset of patients, conscious sedation could be useful to reduce the stress load, together with an early procedure and consequently the minimal use of exogenous stress drugs like Isoprenaline, even if the patient is in a good clinical condition. Conclusions This case highlights TTS as a potential complication after PM implantation, especially in post-menopausal women with high pre-existing stress load.

The Staircase Drive—A Novel Actuator Design Optimised for Daisy-Chaining and Minimum Stress Load Coupling

This work presents a novel type of actuator that improves over the standard cantilever by permitting daisy-chaining while minimising stress to the joint connecting to the load. A detailed structural and functional comparison of the proposed device against the cantilever actuator as a baseline is given, led by a brief revision of the cantilever actuator as the state-of-the-art that highlights its limitations with respect to daisy-chaining and the stress it inherently creates within the joint connecting to the load when attempting out-of-plane displacement without rotation. Simulations of both devices’ performance confirm that the newly proposed device yields the targeted displacement profile that both enables the daisy-chaining of such a device into a higher-order actuator for increased displacement and reduce stress in the joint with the load. This comes at the cost of reduced maximum displacement compared to the cantilever, which can be overcome by daisy-chaining. The proposed device’s performance is further evaluated on the basis of manufactured prototypes measured by means of a laser scanning vibrometer. The prototype was manufactured on a 150m alumina substrate, and both electrodes and piezoelectric layer were deposited in a thick-film printing process.

Resilience and personality as predictors of the biological stress load during the first wave of the Covid-19 pandemic in Germany

Since the Covid-19 outbreak, pandemic-specific stressors have potentiated the—already severe—stress load across the world. However, stress is more than an adverse state, and chronic exposure is causally involved in the development of mental and physical disease. We ask the question whether resilience and the Big Five personality traits predict the biological stress response to the first lockdown in Germany. In a prospective, longitudinal, observational study, N = 80 adult volunteers completed an internet-based survey prior to the first Covid-19-related fatality in Germany (T0), during the first lockdown period (T1), and during the subsequent period of contact restrictions (T2). Hair strands for the assessment of systemic cortisol and cortisone levels were collected at T2. Higher neuroticism predicted higher hair cortisol, cortisone and subjective stress levels. Higher extraversion predicted higher hair cortisone levels. Resilience showed no effects on subjective or physiological stress markers. Our study provides longitudinal evidence that neuroticism and extraversion have predictive utility for the accumulation of biological stress over the course of the pandemic. While in pre-pandemic times individuals high in neuroticism are typically at risk for worse health outcomes, extraverted individuals tend to be protected. We conclude that, in the pandemic context, we cannot simply generalize from pre-pandemic knowledge. Neurotic individuals may currently suffer due to their general emotional lability. Extraverted individuals may primarily be socially stressed. Individualized stress management programs need to be developed, and offered in a lockdown-friendly format, to minimize the stress burden caused by Covid-19 or future pandemics and to protect the most severely affected individuals from the development of stress-associated disease.

Hereditage and socially stress load in the pathogenesis of recurrent depressive disorders

The paper presents the results of a comprehensive clinical-genealogical, clinical-anamnestic and psychodiagnostic examination of patients with recurrent depression. The features, structure and role of heredity factors and social stress factors in the formation of recurrent depression have been investigated. The presence of a significant family accumulation of depressive disorders in the pedigrees was revealed in patients with recurrent depressive disorders, predominantly in the mother’s line. It was found that an important provoking factor in the development of depressive disorders is the presence of factors of mental traumatization, mainly social and psychological. It has been proved that a significant role in the pathogenesis of depression belongs not to the number of stressful events, but to the level of their stressfulness. The results obtained show that the formation of depressive disorders is determined by the presence of a combined effect of clinical and genealogical, social and environmental and socio-psychological factors.