Cognition Assessment in Virtual Reality (CAVIR): Associations with neuropsychological performance and activities of daily living in patients with mood or psychosis spectrum disorders

BACKGROUND

More ecologically valid tools are needed to better capture daily-life cognitive impairments in patients with mood or psychosis spectrum disorders in clinical settings and cognitive treatment trials. We developed the Cognition Assessment in Virtual Reality (CAVIR) test, which assesses daily-life cognitive skills in an immersive virtual reality kitchen scenario. This study investigated the validity and sensitivity of CAVIR, including its association with activities of daily living (ADL) ability.

METHODS

Seventy symptomatically stable patients with mood or psychosis spectrum disorders and 70 healthy controls completed CAVIR and standard neuropsychological tests and were rated for clinical symptoms, functional capacity, and subjective cognition. In addition, patients' ADL ability was evaluated with the Assessment of Motor and Process Skills.

RESULTS

Higher global CAVIR performance correlated moderately with better global neuropsychological test scores (rs(138) = 0.60, p < 0.001) and showed a weak to moderate association with better ADL process ability in patients (r(45) = 0.40, p < 0.01), also after adjusting for sex and age (ps ≤ 0.03). In comparison, neuropsychological performance, interviewer- and performance-based functional capacity, and subjective cognition were not significantly associated with ADL process ability (ps ≥ 0.09). Further, CAVIR was sensitive to cognitive impairments in patients and was able to differentiate between patients with and without the ability to undertake regular employment.

LIMITATIONS

The modest sample size and concomitant medication.

CONCLUSION

Our results indicate that CAVIR is a sensitive measure of daily-life cognitive skills in patients with mood or psychosis spectrum disorders.

Implementing vocational rehabilitation for people with multiple sclerosis in the UK National Health Service: a mixed-methods feasibility study

PURPOSE

To implement a job retention vocational rehabilitation (VR) intervention (MSVR) for people with multiple sclerosis (MS) and their employers in the UK National Health Service (NHS).

METHODS

Multicentre, single-arm feasibility study with post-intervention interviews. MSVR was delivered by an occupational therapist (OT). Feasibility was assessed by recruitment rates, compliance, and practicality of delivery. Acceptability was assessed with post-intervention interviews. A survey assessed change in eight vocational outcomes (e.g., vocational goals, work instability) immediately post-intervention and at 3-month follow-up.

RESULTS

Recruitment and training an OT was challenging. Twenty participants with MS, three employers, and three healthcare professionals were recruited. All participants but one completed the intervention. Factors affecting intervention adherence included annual leave and family responsibilities.MSVR was associated with improved vocational goal attainment post-intervention (t(18) = 7.41, p = <0.001) and at follow-up (t(17) = 6.01, p = <0.001). There was no change to the remaining outcomes. Interviews identified six themes: intervention impact, accessibility of support, the OT's role, readiness for support, workplace supportiveness, and barriers to NHS delivery.

CONCLUSION

Challenges with recruitment, identifying newly diagnosed MS participants, and understanding the OT's training needs to deliver the intervention were identified. The intervention demonstrated acceptability, but participants wanted it to continue for longer to address further needs.

Developmental foundations of Activity-Centered Ergonomics: knowledge encounters to construct both a critical analysis of work and developmental set-ups

This paper presents the developmental foundation of Activity-Centered Ergonomics (ACE) that has been shaped by both: (1) a critique of conceptions of work and of its organisation in relation to economic and political models of development, and (2) developmental approaches to understand and to act on activity and work situations at different levels (individual, collective, organisational, and territorial). To do so, we examine some key reference works for ACE over 75 years with regards to these two dimensions and the methods and developmental set ups proposed. We argue that ACE analytical and transformative goals give a considerable space to knowledge encounters and workers' activity. We conclude by briefly discussing some of the current ACE works seeking to expand research-action over time and level of action (geographical area and public policies), in order to address key societal issues, including sustainable work and development.

Perceived effectiveness of the person-environment-occupation innovative teaching model in rehabilitation therapy students

BACKGROUND

Given the characteristics of the rehabilitation therapy specialty and the drawback of the traditional didactic teaching approach, we developed the innovative teaching approach from the students' perspective using the person-environment-occupation (PEO) model. The new model was developed from the original PEO model to be applied in pedagogical contexts and tailored to the characteristics of an application-oriented specialty, such as rehabilitation therapy. The present study aimed to examine the perceived effectiveness of the PEO innovative teaching model applied to rehabilitation therapy students.

METHODS

A pre-post descriptive study was conducted to compare the perceived effectiveness of the PEO innovative teaching model for two consecutive student cohorts. A purposive sampling method was used to recruit students from two cohorts of junior medical students majoring in rehabilitation therapy in the spring semesters of 2020 and 2021. A questionnaire was developed to evaluate the perceived effectiveness of the PEO innovative teaching model. SPSS version 26.0 was used to perform data analysis.

RESULTS

A total of 112 students were included in the study and completed both pre- and post-tests. Of 112 received questionnaires, 101 were considered as valid questionnaires after the quality check (effective rate 90.18%). In the 2020 and 2021 cohorts, students rated the PEO innovative teaching model significantly higher than the didactic teaching approach in the following aspects: the teaching content is highly professional and valuable; the course is extensively expounded; the clinical reasoning is strengthened; problem-solving ability is developed; communication skills are improved; and teamwork skills are developed.

CONCLUSION

The PEO innovative teaching model was perceived to be an effective teaching strategy to enhance students' academic performance. In addition, three core skills including clinical reasoning, problem-solving ability, and communication skills were improved by the PEO innovative teaching model.

Low psychological resilience and physical fitness predict attrition from US Marine Corps Officer Candidate School training

The objective is to examine the predictors of attrition in male and female candidates undergoing a 10-week early career military training program. 1006 candidates (79.5% male, 24.7 ± 3.2 years) consented to participating in a larger study examining predictors of injury during US Marine Corps Officer Candidates School (OCS). Participants completed a blood draw, demographic and psychological characteristics questionnaires, and two fitness tests. Participants were then grouped based on successful completion of OCS or not. Associations between potential predictors and attrition were analyzed using simple logistic regression analyses, followed by a backward stepwise elimination method. Area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to determine the accuracy of the attrition prediction model. 260 candidates (25.8%) attritted over the 10-week training, with the highest number of discharges during week 5. Musculoskeletal injury (MSKI) was the most common cause of attrition (30%), followed by non-MSKI medical (21.5%), and volitional withdrawals (19.6%). Sex, body mass index (BMI), resilience, initial physical fitness test score, combat fitness test (CFT) score, and prior military service were all significantly associated with attrition from OCS (all p < .05). The final prediction model of attrition included CFT score (p = .027) and resilience (p = .018). Multiple demographic, psychological, and fitness characteristics are associated with attrition from an early career military training course (OCS) and may be utilized as part of early screening procedures to identify and provide guidance for individuals at risk for not completing OCS.

Retirement Transition Sequences and Well-Being Among Older Workers Focusing on Gender Differences

This study examines retirement transition patterns and well-being in later life, focusing on gender differences using data from the 2004-2016 Health and Retirement Study (HRS) with 1,653 older workers. Sequence analysis identifies key retirement patterns, showing that men predominantly transitioned from full-time to mid-time voluntary retirement, while women experienced more gradual involuntary retirement. Involuntary retirees, both men and women, had precarious work histories and poorer mental health. The findings highlight gender-specific implications for social policy and emphasize the need for support in promoting successful aging and reducing social inequities among involuntary retirees.

Lumbar Sitting Behavior of Individuals with Low Back Pain: A Preliminary Study Using Extended Real-World Data

Low back pain affects 619 million people worldwide and is commonly provoked by sitting. Current assessment methods constrain task variability, removing real-world, task-switching behaviors. This study utilized accelerometers to provide an original validated method of in vivo real-world assessment of lumbar sitting behavior throughout a full day. A three-stage study design was used, which involved (1) blinded verification of our sitting detection algorithm, (2) full-day data collection from participants with low back discomfort, quantifying lumbar angles, and end-user acceptability explored, (3) case study application to two clinical low back pain (LBP) patients, incorporating measurement of provocative sitting. Focus group discussions demonstrated that data collection methods were acceptable. Sitting 'windows' were created and analyzed using novel histograms, amplitude probability distribution functions, and variability, demonstrating that sitting behavior was unique and varied across individuals. One LBP patient demonstrated two frequent lumbar postures (<15% flexion and ~75% flexion), with pain provocation at 62% lumbar flexion. The second patient demonstrated a single dominant posture (~90% flexion), with pain provoked at 86% lumbar flexion. Our in vivo approach offers an acceptable method to gain new insights into provocative sitting behavior in individuals with LBP, allowing individualized unconstrained data for full-day postures and pain provocation behaviors to be quantified, which are otherwise unattainable.

Joint associations of handgrip strength and physical activity with incident cardiovascular disease and overall mortality in the UK Biobank

BACKGROUND & AIMS

Questions remain whether higher handgrip strength confers additional health advantages beyond adherence to current physical activity guidelines. We aimed to evaluate prospective associations of joint objectively measured handgrip strength and physical activity with incident cardiovascular disease (CVD) and all-cause mortality.

METHODS

We analysed the UK Biobank study in a cohort of participants who wore accelerometers for one week, with follow-up based on hospital records until 2022. Patterns of physical activity were compared: participants who met current moderate-vigorous physical activity guidelines (150 min per week) and those who did not. Handgrip strength was classified into sex- and age-specific tertiles. CVD events were identified as primary or secondary by examination of inpatient records and data extracted from the death registry. CVD-related deaths were also identified from the death registry. We examined prospective associations of moderate-vigorous physical activity with incident CVD and all-cause mortality by level of handgrip using Cox regressions, adjusted for confounding factors.

RESULTS

A total of 76 074 persons were included (mean 55.2 years). Meeting physical activity guidelines is necessary to reduce all-cause mortality in those at the lower and middle thirds of handgrip strength. However, meeting physical activity guidelines did not confer additional reduction of all-cause mortality of those with high handgrip strength. Those with the lowest handgrip strength showed the greatest benefit from meeting physical activity guidelines for reducing all-cause mortality (HR 0.74; 95 % CI 0.65-0.85).

CONCLUSION

Our results indicate that, while following physical activity guidelines does not reduce mortality in individuals with high handgrip strength, it is essential for preventing cardiovascular disease across all levels of handgrip strength. This underscores the importance of these guidelines for cardiovascular health.

Role function in postmenopausal women during aromatase inhibitor therapy for breast cancer

OBJECTIVE

Few studies have examined aromatase inhibitor therapy relating to role function in breast cancer survivors of working age. Our study sought to identify how pre-therapy sociodemographic and health/treatment-related characteristics, as well as patient-reported symptoms measured every six-months, influence role function during 18 months of AI therapy for early-stage breast cancer.

METHODS

We performed a secondary analysis of longitudinal study data using linear mixed-effects modeling to examine role physical (RP) and role emotional (RE) functioning measured with the Medical Outcome Study Short Form 36 v2. The sample of postmenopausal women (N = 351) consisted of three cohorts: chemotherapy followed by anastrozole (CFAI), anastrozole only (AI only), and non-cancer controls. Our choice of variables and interpretation of findings was theoretically based on the Cancer Survivorship and Work Model. Stepwise backward deletion determined which predictors to include in the final model, accounting for treatment group.

RESULTS

Both treatment groups were associated with greater limitations in RP functioning than controls. CFAI had twice the impact on RP compared to AI only. While the RP model displayed significant predictors across sociodemographic, health/treatment, and symptom characteristics, only symptoms were associated with greater limitations in RE functioning. Findings were significant at p < .05.

CONCLUSION

Transitioning from acute to extended survivorship is a critical juncture in which multiple factors place breast cancer survivors at risk of diminished role function.

IMPLICATIONS FOR CANCER SURVIVORS

Early interventions to address role function limitations during systemic treatment may lead to better work outcomes and improve the quality of long-term survivorship.

Mind-Body Medicine in the Treatment of Depression: A Narrative Review of Efficacy, Safety and Mechanisms

PURPOSE OF THE REVIEW

This narrative review examines the efficacy, mechanisms and safety of mind-body medicine (MBM) in the treatment of depression. We reviewed the potential effects of various MBM interventions such as yoga, tai chi, qigong, mindfulness-based interventions and nutrition on clinical and subthreshold depressive symptoms.

RECENT FINDINGS

Current studies indicate a growing interest in the use of MBM for psychiatric disorders, including depression. MBM interventions demonstrate efficacy in reducing depressive symptoms with fewer adverse effects and costs compared to pharmacological treatments. MBM has significant potential to improve mental health outcomes for depression. These interventions encourage self-care and stress management through behavioural, exercise, relaxation and nutritional approaches. While existing data are promising, further, more rigorous studies are required to confirm long-term effectiveness and to determine the role of MBM in comprehensive depression treatment strategies.

Homeworking experiences of neuro-divergent workers: systematic review

BACKGROUND

Working from home (WFH) is becoming more common, but little is known about how it specifically affects neuro-divergent workers' psychological and occupational well-being.

AIMS

This review aimed to explore the experiences of neuro-divergent staff WFH, including the challenges they face; the potential benefits of homeworking for this specific population and the support systems they require.

METHODS

We searched six electronic databases, as well as reference lists of included papers, one preprint server and Google, for literature on neuro-divergent workers' experiences of WFH. Results were synthesized using thematic analysis.

RESULTS

We reviewed 25 studies (mostly based on data collected during the coronavirus disease 2019 pandemic), finding very little research statistically analysing the impact of WFH on well-being or productivity, or comparing the impact of WFH across neuro-divergent and neuro-typical populations. The (mostly qualitative) findings showed that neuro-divergent participants described various benefits and challenges of the sensory environment at home; the reduction of commuting; increased flexibility and lack of routine when homeworking; the reduction of 'masking' behaviours; lack of in-person social contact and increased use of technology.

CONCLUSIONS

The findings emphasize the importance of not assuming a one-size-fits-all approach to homeworking and suggest managers should be mindful of workers' individual preferences for working whilst ensuring that all employees are appropriately supported. The results can inform future research and provide insights for employers to help them create more inclusive work environments.

Assessing the Turkish version of the Individual Work Performance Questionnaire (IWPQ) for its validity and reliability

BACKGROUNDS

This study aimed to assess the validity and reliability of the Turkish version of the Individual Work Performance Questionnaire (IWPQ).

METHODS

A total of 340 adult participants who had been working for at least 8 h a day completed the study questionnaire online. The questionnaire consisted of sections on demographics and socioeconomic characteristics, the IWPQ, and the ultrashortened version of the Utrecht Work Engagement Scale (UWES-3). Principal component analysis (PCA) with Promax rotation was conducted to assess the e three-factor structure for the Turkish version of the IWPQ. Cronbach's alpha was used to determine internal consistency. The intraclass correlation coefficient (ICC) was used to assess test-retest reliability. Spearman correlation coefficients were calculated between the IWPQ and UWES-3 scales to evaluate convergent validity.

RESULTS

The three factors accounted for a total variance ratio of 60.7%. Cronbach's alphas of three subscales (task performance, contextual performance, and counterproductive work behavior) were 0.894, 0.875, and 0.796, respectively. Test-retest reliability showed high agreement, with ICCs of 0.96, 0.98, and 0.91 for the respective scales. There was a statistically significant correlation between UWES-3 and the task performance subscale (ρ = 0.367 and p < 0.001), a statistically significant correlation between UWES-3 and the contextual performance subscale (ρ = 0.403 and p < 0.001), and a statistically significant correlation between UWES-3 and the CWB subscale (ρ=-0.352 and p < 0.001).

CONCLUSIONS

The Individual Work Performance Questionnaire (IWPQ) identifies work performance.The Turkish version of the IWPQ scales demonstrated validity and reliability in assessing individual work performance.

The prevalence of occupational-related low back pain among working populations in sub-saharan Africa: a systematic review and meta-analysis

INTRODUCTION

Work-related musculoskeletal disorders represent a major public health problem, contributing significantly to the global burden of disability-adjusted life years and affecting the quality of life of all population groups. The main problem in most musculoskeletal disorders is low back pain. Therefore, our study aims to identify the overall prevalence of work-related low back pain among the working population in sub-Saharan Africa.

METHODS

Research published between 2010 and 2023 in English, conducted in Sub-Saharan Africa was included in this systematic review and meta-analysis. Using Boolean logic operators and targeted keywords, we searched for publications on a number of electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The Joanna Briggs Institute Critical Appraisal techniques were utilized to conduct a quality assessment of the papers and ascertain their relevance to the study. The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model. Sensitivity studies were carried out to determine the causes of heterogeneity and the impact of outliers.

RESULTS

In this study, a total of 970 articles were retrieved, and 35 studies were included in the systematic review and meta-analysis. The overall estimated pooled prevalence of low back pain among the working population in sub-Saharan Africa was (55.05% [95% CI: 49.34, 60.76]). Based on a sub-group analysis by countries, the higher pooled prevalence of low back pain was found in Uganda at (61.48% [95% CI: 40.39, 82.57]), while the lower pooled prevalence of low back pain was in Ghana at (34.48% [95% CI: 17.96, 51.01]).

CONCLUSIONS

This systematic review and meta-analysis found that 55.05% of the included study participants experienced low back pain in the previous years. Therefore, it is recommended that policymakers incorporate and enhance strategies for the prevention and management of low back pain within the health system management guidelines of each country.

Different forms of fablab organization and their impact on collaboration and innovation

The aim of this paper is to identify some of the characteristics of innovation and collective work in different fablab organizations. We first define fablabs through a review of literature, situating related questions in the field of ergonomics and focusing our point of view on individual and collective activity. Secondly, we show how the results of our qualitative analyses (performed on data from interviews and observations of fablab managers, users, and projects from 13 fablabs) reveal 3 main types of fablab organization: community-oriented fablabs, academic fablabs and industrial fablabs, in which different activities are carried out. Fablab activity depends on lab users and the type of design projects carried out. The discussion will focus on the fablab organization findings, including the links between design/innovation project work, collective work and evolving rules, and how all of these aspects might direct activity-centered ergonomics research and actions in the future.

Effects of peer-led education on knowledge, attitudes, practices of stoma care, and quality of life in bladder cancer patients after permanent ostomy

Objective

To investigate the effects of peer-led intervention on knowledge, attitudes, and practices (KAP) of stoma care, as well as quality of life in bladder cancer patients post-permanent ostomy.

Methods

A series of 340 eligible bladder cancer patients who underwent permanent ostomy from January 2019 to December 2022 were enrolled in this study. These participants were randomly assigned to the intervention group (peer-led intervention) and the control group (routine health intervention) using random number table, with 170 cases in each group. A 30-item questionnaire was used to evaluate knowledge, healthy attitudes, and healthy practices (KAP) of disease; the WHO Quality of Life-100 (WHOQOL-100) was utilized to assess the quality of life among patients; and the incidence of complications in two groups were also recorded during six-month intervention. For the comparison of continuous variables within and between groups, paired sample and independent t-test were applied. The categorical variables analyzed using x2 test or rank-sum test.

Results

After six-month intervention, 144 participants in the intervention group and 151 participants in the control group were finally retained in this study. The scores of the 20 items in KAP (including basic knowledge of disease, basic knowledge of ostomy, observation of stoma, etc.) in the intervention group were significantly higher than those in the control group (all p < 0.05); the scores of 12 items in WHOQOL-100 (including the positive feelings, thinking, learning, memory and concentration, etc.) in the intervention group were markedly higher than those in the control group, while negative feelings and dependence on medical support in the intervention group were significantly lower than those in the control group (all p < 0.05); the total rate of complications in the intervention group was significantly lower than that in the control group (18.31% vs. 31.13%, p < 0.05).

Conclusion

The peer-led intervention has a positive effect on improving patients' KAP of stoma care and quality of life and reducing the rate of complications, which enables it to be a favorable intervention approach for patients with permanent ostomy.

An unbiased, sustainable, evidence-informed Universal Food Guide: a timely template for national food guides

BACKGROUND

Although national food guides are designed, ostensibly, to translate scientific evidence with respect to food, dietary patterns, and health, their development has increasingly become a corporate/political process as well as scientific one; often with corporate/political influences overriding science. Our aim was to construct an unbiased, sustainable, evidence-informed Universal Food Guide to serve as a template for countries to develop their unique guides, thereby, provide a valid resource for health professionals, health authorities, and the public.

METHODS

To address our aim, we conducted an integrative review of multiple evidence-informed sources (e.g., established databases, evidence syntheses, scholarly treatises, and policy documents) related to four areas: 1. Food guides' utility and conflicts of interest; 2. The evidence-based healthiest diet; 3. Constituents of the Universal Food Guide template; and 4. Implications for population health; regulation/governance; environment/climate/planetary health; and ethics.

RESULTS

The eating pattern that is healthiest for humans (i.e., most natural, and associated with maximal health across the life cycle; reduced non-communicable disease (NCD) risk; and minimal end-of-life illness) is whole food, low fat, plant-based, especially vegan, with the absence of ultra-processed food. Disparities in national food guide recommendations can be explained by factors other than science, specifically, corporate/political interests reflected in heavily government-subsidized, animal-sourced products; and trends toward dominance of daily consumption of processed/ultra-processed foods. Both trends have well-documented adverse consequences, i.e., NCDs and endangered environmental/planetary health. Commitment to an evidence-informed plant-based eating pattern, particularly vegan, will reduce risks/manifestations of NCDs; inform healthy food and nutrition policy regulation/governance; support sustainable environment/climate and planetary health; and is ethical with respect to 'best' evidence-based practice, and human and animal welfare.

CONCLUSION

The Universal Food Guide that serves as a template for national food guides is both urgent and timely given the well-documented health-harming influences that corporate stakeholders/politicians and advisory committees with conflicts of interest, exert on national food guides. Such influence contributes to the largely-preventable NCDs and environmental issues. Policy makers, health professionals, and the public need unbiased, scientific evidence as informed by the Universal Food Guide, to inform their recommendations and choices.

Paper-and-Pencil vs. Electronic Patient Records: Analyzing Time Efficiency, Personnel Requirements, and Usability Impacts on Healthcare Administration

Background: This study investigates the impact of transitioning from paper and pencil (P&P) methods to electronic patient records (EPR) on workflow and usability in surgical ward rounds. Methods: Surgical ward rounds were audited by two independent observers to evaluate the effects of transitioning from P&P to EPR. Key observations included the number of medical personnel and five critical workflow aspects before and after EPR implementation. Additionally, usability was assessed using the System Usability Scale (SUS) and the Post-Study System Usability Questionnaire (PSSUQ). Results: A total of 192 P&P and 160 EPR observations were analyzed. Physicians experienced increased administrative workload with EPR, while nurses adapted more easily. Ward teams typically consisted of two physicians and three or four nurses. Usability scores rated the system as "Not Acceptable" across all professional groups. Conclusions: The EPR system introduced usability challenges, particularly for physicians, despite potential benefits like improved data access. Usability flaws hindered system acceptance, highlighting the need for better workflow integration. Addressing these issues could improve efficiency and reduce administrative strain. As artificial intelligence becomes more integrated into clinical practice, healthcare professionals must critically assess AI-driven tools to ensure safe and effective patient care.

Electromyography Parameters to Discriminate Hand Osteoarthritis and Infer Their Functional Impact

Surface-electromyography (sEMG) allows investigators to detect differences in muscle activation due to hand pathologies. However, its use as a functional indicator and the challenges related to the required normalization have not been fully addressed. This study aimed to use forearm muscle sEMG signals to distinguish between healthy individuals and patients with hand osteoarthritis (HOA). sEMG data were collected from seven sensors on the forearms of twenty-one healthy women and twenty women with HOA during the Sollerman test. Amplitude-based parameters (median and range) were normalized using three methods: maximum signals during Sollerman tasks (MAX), during maximum voluntary contraction tasks (MVC), and during maximum effort grasping (GRASP). Waveform parameters (new-zero-crossing and enhanced-wavelength) were also considered. MVC and GRASP resulted in higher values in patients. Discriminant analysis showed the worst success rates in predicting HOA for amplitude-based parameters, requiring extra tasks for normalization (MVC or GRASP), while when using both amplitude (MAX) and waveform parameters and only Sollerman tasks, the success rate reached 90.2% Results show the importance of normalization methods, highlight the potential of waveform parameters as reliable pathology indicators, and suggest sEMG as a diagnostic tool. Additionally, the comparison of sEMG parameters allows the functional impact of suffering from HOA to be inferred.

Work Disparities and the Health of Nurses in Long-Term Care: A Scoping Review

Work disparities, such as unfairness in pay or unequal distribution of work experienced by nurses in long-term care (LTC), can impact the retention and health of this workforce. Background: Despite the significant impact of disparities on nurses' health in LTC, a literature review on work disparities of nurses in LTC has not been conducted. Method: This scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and its links with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), SCOPUS, and CINAHL (EBSCO host). Results: Of the 5652 articles retrieved, 16 studies (14 quantitative and 2 qualitative) published between 1997 and 2024 met the inclusion criteria. A total of 53 work disparities were identified. Only four articles investigated the association of a work disparity with a variable of health (e.g., physical, mental, or poor general health). Conclusions: The results suggest that more attention to how disparities impact nurses' health and lived experiences is warranted. Meso-level disparities from this review provide an initial basis to consider possibilities in the workplace, especially in supporting equity and opportunities for health and well-being at work (e.g., through fair access to professional growth opportunities and a more equitable balance of work expectations and demands of nursing staff). Future studies of the intersection of macro- and meso-level factors are needed to inform better workplace practices and social and economic policies to support the well-being, health, and safety of nurses at work in LTC.

How do adults with hearing loss, family members, and hearing care professionals respond to the stigma of hearing loss and hearing aids?

OBJECTIVE

To investigate the perspectives and experiences of adults with hearing loss (HL), their family members, and hearing care professionals on how they respond to the stigma of HL and hearing aids (HAs).

DESIGN

Qualitative descriptive approach using semi-structured interviews.

STUDY SAMPLE

Three participant groups were recruited, including 20 adults over the age of 50 years with HL, 20 family members who had a close relationship to the adults with HL, and 25 hearing care professionals.

RESULTS

Three themes described how adults with HL, family members, and hearing care professionals respond to the stigma of HL and HAs, namely: (1) some people tell others about their HL and HAs and some people don't; (2) telling or not telling depends on the situation; and (3) people deal with the stigma of HL and HAs in different ways.

CONCLUSIONS

This study revealed a range of volitional responses to the stigma of HL and HAs. People affected by HL may not tell others about their HL and/or HAs because of the stigma, and these volitional responses are influenced by situational cues. Adults with HL and family members manage the stigma of HL and HAs in different ways and require a person-centred approach.

Prevalence and Interrelationships of Screen Time, Visual Disorders, and Neck Pain Among University Students: A Cross-Sectional Study at Majmaah University

BACKGROUND

Digital devices significantly contribute to vision-related problems. In addition, prolonged postural imbalance, owing to excessive use of digital devices, can lead to the tightening of head and neck muscles, resulting in neck pain, a common musculoskeletal discomfort that significantly affects individuals with poor vision. This study aimed to evaluate the prevalence and interrelationships of screen time, visual disorders, and neck pain among students at Majmaah University.

METHODS

A cross-sectional study was conducted at Majmaah University, Saudi Arabia, enrolling students aged 18 to 25 years. Exclusion criteria included neurological or musculoskeletal disorders. Demographic data and information on visual and neck pain symptoms were collected. The Neck Disability Index questionnaire was used to assess neck pain, and data were analyzed using SPSS version 24.0.

RESULTS

Among 263 participants, 53.6% were female. Nearsightedness (38.0%) and dry/itchy eyes (49.0%) were the most common visual disorders and symptoms, respectively. Visual disorders were prevalent in 62.0% of students, while neck pain was reported by 79.5%. Females and those studying for more than 5 h using electronic screens daily reported higher neck disability index scores. A significant association was found between >5 h of study duration [screen time] and neck disability (OR 3.703, 95% CI 1.500-9.144, p = 0.005).

CONCLUSION

The study highlights a relationship between visual problems and neck pain among university students, emphasizing the need for addressing vision-related issues to reduce neck discomfort. High screen time could substantially increase the odds of developing neck disability. However, authors warrant cautious interpretation in the light of following limitations: cross-sectional study, small sample size, lack of statistical power, and self-reported data.

Demystifying Obesity: Understanding, Prevention, Treatment, and Stigmas

Obesity is a complex chronic disease that affects millions of people worldwide. There is still significant stigma associated with it, which can lead to discrimination and create additional barriers for people who are already in treatment. On the other hand, it is noted that it can have serious implications for health and predisposition to noncommunicable chronic diseases. In this sense, the objective of this study was to carry out a narrative review involving all current elements for understanding, prevention, treatment, and debate of stigmas related to obesity. A search was conducted in 2024 for original articles, randomized or nonrandomized clinical trials, systematic reviews, meta-analyses, and guidelines in the following databases: Pubmed, Scielo, Web of Science, CrossRef, and Google Scholar. The publication period was from 2014 to 2024. Obesity is influenced by a complex combination of genetic, environmental, and psychological factors. It is encouraging to see that various emerging points have been identified across different fields such as histology, physiology, genetics, weight loss, and public policy. These obesity areas certainly warrant attention and future studies. Researchers can delve into these topics to deepen their understanding and potentially uncover novel insights. The management should be multifactorial and individualized for each patient. Public policies also play a crucial role in combating obesity, including health promotion, prevention of excessive weight gain, early diagnosis, and proper care of patients. It is crucial that society begins to see the disease as an extremely complex element and not as a moral failure or lack of willpower. This requires a change in the way people talk about obesity, as well as practices that support people instead of stigmatizing them. Obesity does not have a specific address, color, or race. It belongs to everyone and should be regarded as a global public health problem.

Rate, risk factors, and clinical outcomes of SARS-CoV-2 reinfection vs. primary infection in readmitted COVID-19 patients in Iran: a retrospective cohort study

Background

Corona Virus Disease 2019 (COVID-19) has severely impacted global health, resulting in high morbidity and mortality, and overwhelming healthcare systems, particularly in Iran. Understanding reinfection is crucial as it has significant implications for immunity, public health strategies, and vaccine development. This study aims to identify rate and the risk factors associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reinfection and compare the clinical course of initial infection versus reinfection in readmitted COVID-19 patients in Iran.

Methods

This retrospective cohort study was conducted from January 2020 to the end of 2022 in five hospitals in Iran. The study compared demographic and clinical data, vaccination status, and clinical outcomes between patients with reinfection (defined as a positive PCR test for SARS-CoV-2 at least 90 days after the primary admission) and a control group (patients who had an initial confirmed SARS-CoV-2 infection but were not readmitted with a positive PCR test for SARS-CoV-2 at least 90 days after their primary infection). Risk factors for reinfection were evaluated using a regression model. Propensity score matching (PSM) was used to compare post-clinical and laboratory outcomes between the matched case and control groups.

Results

Out of 31,245 patients, 153 (0.49%) experienced reinfections. The reinfection rate was significantly higher during B.1.617.2 and B.1.1.529 variant wave (p < 0.001). After multivariable regression analysis, incomplete vaccination status (OR: 1.68, 95% CI: 1.34-2.31, p = 0.021) and lack of booster vaccination (OR: 2.48, 95% CI: 1.96-3.65, p = 0.001) were the risk factors for reinfection. Furthermore, reinfection was associated with atypical COVID-19 symptoms, and shorter ICU and hospital stays (p < 0.001). The B.1.1.529 variant was significantly more common among reinfected patients (p < 0.001).

Conclusion

SARS-CoV-2 reinfections are more frequently observed during waves of novel variants and are associated with a milder clinical course and shorter hospital stays. Full vaccination and booster doses can effectively reduce the risk of SARS-CoV-2 reinfections.

Influence of personal and career burnout on female employers' subjective evaluation of workplace acoustic environment

BACKGROUND

Burnout is an increasingly common problem in modern work settings that significantly affects people's health and well-being. Several studies have emphasized the impact of career burnout on employees' performance and efficiency. It is unknown whether career burnout mediated by personal burnout may affect employees' perception of their workplace physical environment attributes.

OBJECTIVES

This research aims to understand if personal and career burnout can affect employers' acoustic environment evaluation of their workplace.

METHOD

Considering commonly experienced or highly experienced personal and career burnout among working women, the study targeted female university faculty members. The research involved stratified sampling and employed data from 272 individuals across five public and private universities in Tehran. Collected data were analyzed using SmartPLS (latest release 4.1).

RESULTS

The results revealed a significant link between personal and career burnout and the subjective evaluation of workplace acoustic environment. Career burnout mediated the relationship between personal burnout and negative evaluation of the workplace acoustic environment.

CONCLUSION

This study provides compelling evidence that experiences of burnout, whether related to personal or career aspects, substantially impact the subjective assessment of the acoustic environment within the workplace. The results underscore the complex interplay between an individual's degree of burnout and their subjective perception of the acoustic dimensions of their work environment. The findings extend our understanding of how psychological factors might shape our interpretation of the physical workplace.

Knowledge, attitude, and practice toward sleep hygiene and cardiovascular health: a cross-sectional survey among healthcare workers

Background

Healthcare workers grapple with distinct challenges, inherent to their profession, making them susceptible to irregular sleep patterns and insufficient sleep, which may further impact their cardiovascular health. This study aimed to investigate the knowledge, attitude and practice (KAP) of healthcare workers concerning sleep hygiene and cardiovascular health.

Methods

A cross-sectional survey was conducted at Yancheng TCM Hospital Affiliated with Nanjing University of Chinese Medicine between July, 2023 and September, 2023. Demographic characteristics, KAP scores, sleep health awareness and habits, and sleep quality were assessed through the questionnaires.

Results

A total of 423 valid questionnaires were included in the study. Among these, 215 (50.83%) were aged 35 or below, and 128 (30.26%) reported suffering from chronic insomnia. The mean knowledge, attitude, and practice scores were 43.23 ± 5.67 (possible range: 10-50), 24.53 ± 4.59 (possible range: 9-45), and 20.22 ± 4.46 (possible range: 6-30), respectively. Multivariate analyses indicated that attitude score (OR = 0.890, 95% CI: [0.807-0.981], p = 0.019), sleep health awareness & habits score (OR = 1.847, 95% CI: [1.284-2.656], p = 0.001), experienced chest tightness or heart palpitations (OR = 6.084, 95% CI: [2.172-17.042], p = 0.001), and the presence of chronic insomnia (OR = 5.017, 95% CI: [2.428-10.368], p < 0.001) were independently associated with sleep quality.

Conclusion

Healthcare workers had adequate knowledge, negative attitude and moderate practice toward sleep hygiene and cardiovascular health. The findings highlight the need for targeted interventions to address the observed gaps in attitudes and practices, aiming to enhance overall awareness and promote healthier sleep habits among healthcare professionals.

Meaning of Work Participation After Spinal Cord Injury in Bangladesh: A Qualitative Study in a Low- and Middle-Income Country Context

PURPOSE

This study aimed to explore the meaning of work participation for people with spinal cord injury (SCI) in Bangladesh.

METHODS

Narrative inquiry methodological framework was used to explore the meaning of work participation after SCI. Face-to-face interviews with twenty adults with SCI, who were either living in the community or in-patients at a rehabilitation center. The Worker Role Interview questionnaire was used as an interview guide. Participants were descriptively analyzed in two groups, rehabilitation participants and community participants. Their transcripts were analyzed using individual narrative analysis to understand the meaning of their experience at an individual level and then the findings from the individual narrative analyses were summarized using thematic analysis to identify themes that collectively represented the meaning of work after SCI in Bangladesh.

RESULT

Five themes were identified from the interviews: "work life before injury"; "current life in relation to work"; "framing future prospects of work participation"; "motives for working"; and "enablers of work participation."

CONCLUSION

The meaning of work is subjective and is influenced by the participants' pre-existing experiences and other factors related to their work life, such as work preferences, habits, and daily routines. Therefore, creating opportunities to better understand the meaning of work for each individual and incorporating these factors into rehabilitation are keys to sustainable rehabilitation outcomes.

Depression and its associated factors among health care workers in Saint Paul's hospital millennium medical college, Ethiopia

BACKGROUND

Depression is a common mental disorder that affects 3.8% of the general population and 24% of healthcare workers globally. Healthcare professionals are more susceptible to depression because they face higher amounts of professional stress in their jobs and academic lives. However, there is limited knowledge regarding health professionals' level of depression in Ethiopia. This study aimed to assess the prevalence of depression and associated factors among health professionals, at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

METHODS

We conducted an institution-based cross-sectional study among 439 randomly selected healthcare workers using interviewer-administered patient health questionnaire-9 from April to May 2023. Ordinal logistic regression was performed to identify predictors of depression. Reported p-values < 0.05 or a 95% Confidence Interval of Odds Ratio excluding one was considered statistically significant.

RESULT

The overall prevalence of depression among healthcare workers was 21.9% (95%CI: 18%, 27.76%). There were reports of mild (35%), moderate (13%) and severe (9%) depression, respectively. Marital status of being single (AOR = 7.78, 95%CI: 1.123, 49.01), history of childhood abuse (AOR = 2.57, 95%CI:1.49, 4.42), history of suicidal attempt (AOR = 2.66, 95%CI:1.25,5.67), having a history of stressful life event (AOR = 1.527, 95%CI: 1.02,2.3), back pain over the past 30 days (AOR = 2, 95%CI: 1.30,3.11), working for more than 8 hours (AOR = 3.03, 95%CI: 1.12,8.24), and having experience of 5-10 year (AOR = 4, 95%CI: 1.05,15.27) and 10-15 years (AOR = 4.24, 95%CI: 1.08,16.58) and poor social support (AOR = 2.09, 95%CI: 1.09,3.99) were statistically associated with increased level of depression.

CONCLUSION

Healthcare professionals' higher rate of depression was due to the higher workload, childhood abuse, history of stressful life, back pain, and poor social support. Thus, the hospital should give special attention to early screening and treatment for depression for those healthcare workers who have a high workload, childhood abuse, back pain, a history of stressful life and poor social support. Similarly, the Ministry of Health should also design strategies to screen, detect and treat depression among healthcare workers.

Conceptualising the quality experience for independent medical examinations: A narrative review

BACKGROUND

An independent medical examination is a unique healthcare assessment conducted by an expert health professional with the aim of providing impartial advice to key stakeholders in workers' compensation schemes regarding a worker's injury or illness. A range of dedicated guidelines provide for best practice at local and national levels, but concerns exist regarding the quality of these encounters for all involved.

METHODS

A narrative review was conducted to explore quality principles underpinning practices and reporting of independent medical examinations. Quality was defined by dimensions outlined by the World Health Organization (effectiveness, safety, people-centredness, timeliness, equity, integration of care, efficiency). Academic (databases: Medline, CINAHL, Embase) and grey literature (advanced Google search) published in English was searched with no date limits. Results were synthesised according to the components of independent medical examinations (independent medical examiner approval and selection, independent medical examinations, reporting) and then mapped to quality dimensions.

RESULTS

The quality dimensions of effectiveness, safety, person-centredness, timeliness, equity, and efficiency were partly addressed in existing independent medical examination practices, most commonly within the examination itself. However, there were prominent gaps in person-centredness and integration of care across all stages of the examination and reporting process. Opportunities for strengthening quality practices included: inviting community members with lived experience of workplace injury to serve on boards responsible for appointing independent medical examiners; explicitly encouraging questions and perspectives from injured works during examinations; holistic reporting that accurately captures injured workers' experiences; consultations with usual treating teams prior to report finalisation and submission; and providing verbal summaries and/or reports directly to injured workers.

CONCLUSION

Although some quality principles were evident in existing independent medical examination practices described in the literature, unlike the acute and community healthcare sectors, the notion of quality was not universally applied in this context. To promote evidence-based practice, foster positive cultural shifts, and enhance experiences of injured workers and independent medical examiners, formally embedding a comprehensive quality experience in independent medical examination programs is recommended.

Constructing a measure for self-perceived open organizational culture in a university hospital pharmacy

Background

An open organizational culture in the workplace represents an environment where information, ideas, and feedback are freely exchanged among all members, regardless of position or rank. Currently, there are no valid survey instruments to measure this culture within a healthcare context. To address this gap, we developed a survey instrument to measure self-perceived open organizational culture at a university pharmacy using a test re-test study design.

Methods

Data were collected during classroom training on basic mediation skills study. Participants completed the same questionnaire before (test phase) and after the training (validation phase). The questionnaire included statements assessing open organizational culture. The data were analyzed using standardized psychometric methods, including correlations, Exploratory Factor Analysis (structural validity), and construct validity by correlating the open organizational culture scores with the Interpersonal Communication Inventory.

Results

In the test phase, 191 participants (161 females, 84%; response rate = 39.7%) contributed to the initial construction of the self-perceived open organizational culture survey instrument. In the validation phase, 81 of the original respondents completed the questionnaire again. Three latent factors were identified, retaining 22 of the 37 items: "enabling systems" (7 items), "open behavior" (8 items), and "trusting and supporting coworkers" (7 items). High correlations were found among the three factors (r > 0.6), and between these factors and the Interpersonal Communication Inventory (r > 0.35). Cronbach's alphas were all above 0.85, indicating good internal consistency. During the validation phase, the factors demonstrated high internal consistency, test/re-test correlations, and agreement.

Conclusion

This study presents a 22-item survey instrument for measuring individual differences in self-perceived open organizational culture within a university hospital pharmacy. The instrument demonstrates internal consistency and construct validity. Further validation of its psychometric properties and testing in other healthcare departments are recommended.

Unveiling public perceptions at the beginning of lockdown: an application of structural topic modeling and sentiment analysis in the UK and India

BACKGROUND

The appearance of the COVID-19 virus in December 2019, quickly escalated into a global crisis, prompting the World Health Organization to recommend regional lockdowns. While effective in curbing the virus's spread, these measures have triggered intense debates on social media platforms, exposing widespread public anxiety and skepticism. The spread of fake news further fueled public unrest and negative emotions, potentially undermining the effectiveness of anti-COVID-19 policies. Exploring the narratives surrounding COVID-19 on social media immediately following the lockdown announcements presents an intriguing research avenue. The purpose of this study is to examine social media discourse to identify the topics discussed and, more importantly, to analyze differences in the focus and emotions expressed by the public in two countries (the UK and India). This is done with an analysis of a big corpus of tweets.

METHODS

The datasets comprised of COVID-19-related tweets in English, published between March 29th and April 11th 2020 from residents in the UK and India. Methods employed in the analysis include identification of latent topics and themes, assessment of the popularity of tweets on topic distributions, examination of the overall sentiment, and investigation of sentiment in specific topics and themes.

RESULTS

Safety measures, government responses and cooperative supports are common themes in the UK and India. Personal experiences and cooperations are top discussion for both countries. The impact on specific groups is given the least emphasis in the UK, whereas India places the least focus on discussions related to social media and news reports. Supports, discussion about the UK PM Boris Johnson and appreciation are strong topics among British popular tweets, whereas confirmed cases are discussed most among Indian popular tweets. Unpopular tweets in both countries pay the most attention to issues regarding lockdown. According to overall sentiment, positive attitudes are dominated in the UK whilst the sentiment is more neutral in India. Trust and anticipation are the most prevalent emotions in both countries. In particular, the British population felt positive about community support and volunteering, personal experiences, and government responses, while Indian people felt positive about cooperation, government responses, and coping strategies. Public health situations raise negative sentiment both in the UK and India.

CONCLUSIONS

The study emphasizes the role of cultural values in crisis communication and public health policy. Individualistic societies prioritize personal freedom, requiring a balance between individual liberty and public health measures. Collectivistic societies focus on community impact, suggesting policies that could utilize community networks for public health compliance. Social media shapes public discourse during pandemics, with popular and unpopular tweets reflecting and reshaping discussions. The presence of fake news may distort topics of high public interest, necessitating authenticity confirmation by official bloggers. Understanding public concerns and popular content on social media can help authorities tailor crisis communication to improve public engagement and health measure compliance.

Associations of Personal Hourly Exposures to Air Temperature and Pollution with Resting Heart Rate in Chronic Obstructive Pulmonary Disease

Previous studies linked higher daily ambient air temperature and pollution with increased cardiorespiratory morbidity, but immediate effects of personal, hourly exposures on resting heart rate remained unclear. We followed 30 older former smokers with chronic obstructive pulmonary disease (COPD) in Massachusetts for four nonconsecutive 30-day periods over 12 months, collecting 54,487 hourly observations of personal air temperature, fine particulate matter (PM2.5), nitrogen dioxide (NO2), ozone (O3), and resting heart rate. We explored the single lag effects (0-71 h) and cumulative effects (0-5 h, the significant lag windows) of air temperature and pollution on resting heart rate using generalized additive mixed models with distributed lag nonlinear models. Single lag effects of higher air temperature and pollutants on higher resting heart rate were most pronounced at lag 0 to 5 h. Cumulative effects of higher air temperature, PM2.5, O3, and NO2 (each interquartile range increment) on higher resting heart rate at lag 0-5 h, show differences of (beats per minute [bpm], 95% CI) 1.46 (1.31-1.62), 0.35 (0.32-0.39), 2.32 (2.19-2.45), and 1.79 (1.66-1.92), respectively. In conclusion, higher personal hourly air temperature, PM2.5, O3, and NO2 exposures at lag 0-5 h are associated with higher resting heart rate in COPD patients.

Correlation between sagittal balance and thoracolumbar elastic energy parameters in 42 spines subject to spondylolisthesis or spinal stenosis and 21 normal spines

The curvature of the lumbar spine plays a critical role in maintaining spinal function, stability, weight distribution, and load transfer. We have developed a mathematical model of the lumbar spine curve by introducing a novel mechanism: minimization of the elastic bending energy of the spine with respect to two biomechanical parameters: dimensionless lumbosacral spinal curvature c LS and dimensionless curvature increment along the spine CI. While most of the biomechanical studies focus on a particular segment of the spine, the distinction of the presented model is that it describes the shape of the thoracolumbar spine by considering it as a whole (non-locally) and thus includes interactions between the different spinal levels in a holistic approach. From radiographs, we have assessed standard geometrical parameters: lumbar lordosis LL, pelvic incidence PI, pelvic tilt PT, sacral slope ψ0 and sagittal balance parameter SB = sagittal vertical axis (SVA)/sacrum-bicoxofemoral distance (SFD) of 42 patients with lumbar spinal stenosis (SS) or degenerative spondylolisthesis (SL) and 21 radiologically normal subjects. SB statistically significantly correlated with model parameters c L5 (r = -0.34, p = 0.009) and -CI (r = 0.33, p = 0.012) but not with standard geometrical parameters. A statistically significant difference with sufficient statistical power between the patients and the normal groups was obtained for c LS, CI, and SB but not for standard geometrical parameters. The model provides a possibility to predict changes in the thoracolumbar spine shape in surgery planning and in assessment of different spine pathologies.

Status and influencing factors of nurses' organizational silence in general hospitals in eastern coastal cities of China

AIMS

This study investigated the status and influencing factors of organizational silence among 624 nurses in general hospitals in eastern coastal cities of China.

METHODS

This study followed STROBE guidelines. During the period from January to April 2024, the researchers investigated 624 clinical in-service nurses in terms of general information, employee silence behavior, work engagement, and peer support, and analyzed the related factors affecting nurses' organizational silence.

RESULTS

The total average score of nurses' organizational silence was (33.88 ± 6.88), and the total score of work engagement was (69.23 ± 10.76); The total score of the colleague support scale was (90.02 ± 13.72), which was at the medium level. Univariate analysis showed that the scores of organizational silence of 610 nurses had statistical differences in departments, employment methods and professional titles (P < 0.05); Pearson correlation analysis showed that nurses' work engagement (r=-0.530, P < 0.05), perceived colleague support a scale (r=-0.530, P < 0.05), colleague support B scale (r=-0.363, P < 0.05) were negatively correlated with organizational silence; Multiple linear regression analysis showed that department (β'value = 0.256, P = 0.001), employment mode (β'value = 0.115, P = 0.001), professional title (β'value = 0.741, P = 0.023), working years (β'value = 1.1110, P = 0.000), work engagement (β'value6.182, P = 0.000), colleague support scale A (β'value = 0.198, P = 0.003), and scale B (β'value = 0.485, P = 0.001) were the main influencing factors of nurses' organizational silence behavior.

CONCLUSIONS

In this study, nurses' organizational silence is at the medium level, and nursing workers with low outpatient service, contract system, professional title and working years, less work investment and poor support from colleagues are prone to silence behavior.

The Effect of Stretching Exercises Applied to Caregivers of Children with Development Disabilities on Musculoskeletal Muscle Mobility and Respiratory Function

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children with developmental delays using a crossover randomized study design. Posterior muscle chain mobility was assessed using the popliteal angle test (PAT) for the hamstring muscle, the mobility of the lumbar muscles was assessed using the Schober test (ST), and the mobility of the posterior chain muscles as a whole was assessed using the finger-to-floor distance test. Chest mobility was measured using chest circumference measurements and lung volumes were measured using the pulmonary function test (PFT). The results showed that stretching exercises applied to the hamstrings led to significant improvements in PAT, ST, and chest mobility in the direction of maximal expiration (p < 0.05), without being superior to each other. Ten males (33.3%) and twenty females (66.7%) who met the inclusion criteria were analyzed. The mean age of the participants was 26.6 ± 5.9 years, the mean height was 169.53 ± 8.67 cm, the mean weight was 65.26 ± 12.03 kg, and the mean body mass index was 22.58 ± 3 kg/m2. Chest inspiratory mechanics also showed a low positive correlation with posterior muscle mobility (r = 0.381; p = 0.038). There was no significant change in PAT. Within the framework of the myofascial theory, stretching exercises that can contribute positively to the musculoskeletal and respiratory system structures of healthcare professionals can be recommended and encouraged to healthcare professionals.

Designing and optimizing clinical trials for long COVID

Long COVID is a debilitating, multisystemic illness following a SARS-CoV-2 infection whose duration may be indefinite. Over four years into the pandemic, little knowledge has been generated from clinical trials. We analyzed the information available on ClinicalTrials.gov, and found that the rigor and focus of trials vary widely, and that the majority test non-pharmacological interventions with insufficient evidence. We highlight promising trials underway, and encourage the proliferation of clinical trials for treating Long COVID and other infection-associated chronic conditions and illnesses (IACCIs). We recommend several guidelines for Long COVID trials: First, pharmaceutical trials with potentially curative, primary interventions should be prioritized, and both drug repurposing and new drug development should be pursued. Second, study designs should be both rigorous and accessible, e.g., triple-blinded randomized trials that can be conducted remotely, without participants needing to leave their homes. Third, studies should have multiple illness comparator cohorts for IACCIs such as myalgic encephalomyelitis (ME/CFS) and dysautonomia, and screen for the full spectrum of symptomatology and pathologies of these illnesses. Fourth, studies should consider inclusion/exclusion criteria with an eye towards equity and breadth of representation, including participants of all races, ethnicities, and genders most impacted by COVID-19, and including all levels of illness severity. Fifth, involving patient-researchers in all aspects of studies brings immensely valuable perspectives that will increase the impact of trials. We also encourage the development of efficient clinical trial designs including methods to study several therapies in parallel.

Impact of a 6-month sit-stand desk-based intervention on regional musculoskeletal discomfort and overall post-work fatigue in office workers: a cluster randomised controlled trial

Evaluate the impact of a 6-month sit-stand desk (SSD) intervention on office workers' regional musculoskeletal discomfort (MD) and overall post-work fatigue (PWF) compared to a control group. A two-arm (1:1) clustered randomised controlled trial including 38 participants (aged 24-60 years, 77% women) assigned to intervention or control groups. The intervention, spanning 6 months, involved psychoeducation, motivational prompts, and SSD. The control group maintained standard working conditions. MD was assessed using the Nordic Musculoskeletal Questionnaire, and PWF with the Need for Recovery Scale. ANCOVA was employed to compare groups, adjusting for covariates, with 5% significance. The intervention group reduced overall MD (p = 0.018) and PWF (p = 0.013), while the control group showed no changes. However, no time*group interactions were found (p > 0.05). A 6-month SSD intervention alleviated office workers' MD and PWF, suggesting benefits from increasing standing time by at least 30 minutes/day. Future investigations must explore individual heterogeneity in response to SSD.

TRIAL REGISTRATION

https://doi.org/10.17605/OSF.IO/JHGPW.

The association between sleep disorder, sleep duration and chronic back pain: results from National Health and Nutrition Examination Surveys, 2009-2010

BACKGROUND

Back pain is a typical condition, and the association among sleep disorders, sleep duration and back pain is currently being investigated. The purpose of this research is to explore the connection between sleep disorders, sleep duration and chronic back pain as well as confounding factors.

METHODS

Our data were obtained from the National Health and Nutrition Examination Survey (NHANES) data set of the USA and 1,131 participants were included in the study. Multivariable logistic regression was employed to investigate the relationship between sleep disorders, sleep duration and chronic back pain. And subgroup analysis conducted by gender, age, race, education, marital status, PIR, BMI, awakening events, hypertension condition and diabetes condition was also performed.

RESULTS

Our study includes 1131 participants, 513 are men (45.4%) and 618 are women (54.6%), 151 participants with sleep disorders (13.4%) and 980 participants without (86.6%). The fully adjusted model with adjustment variables including age, gender, race, BMI, PIR, drink, smoke, education, marital status, awakening conditions, hypertension, diabetes and part of back pain constructed through multiple logistic regression shows that chronic back pain is associated with sleep disorders [OR = 3.71, 95% CI: (1.25, 10.99), p < 0.05]. Using normal sleep duration as a reference, there is no statistical difference between short sleep duration [OR=-0.35, 95% CI: (-0.95, 0.24), p = 0.241], long sleep duration [OR = 0.81, 95% CI: (-1.61, 3.24), p = 0.513] and chronic back pain. It can be found through subgroup analysis that age between 40 and 60 years, age larger than 60 years, different race, marital status and BMI >30 kg/m2 are associated with chronic back pain and sleep disorders. We also find a nonlinear relation which is likely to be rotated S-shape among chronic back pain and sleep duration by fitting smooth curves.

CONCLUSION

Our results suggest a substantial positive relationship between chronic back pain and sleep disorders and there is no statistical association between sleep duration and chronic back pain. The findings drawn from our study provide a basis for future exploration of the causal association between chronic back pain and sleep disorders, and provide references for timely elimination of interfering factors.

Ill persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence

In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.

Musculoskeletal disorders among sonographers: a systematic review and meta-analysis

INTRODUCTION

The job of sonographers exposes them to numerous ergonomic risk factors, making the sonography profession one of the high-risk job groups vulnerable to musculoskeletal disorders (MSDs). The present systematic review and meta-analysis specifically examined the prevalence of MSDs among sonographers.

MATERIALS AND METHODS

The present review study was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The protocol of the study was registered in the international prospective register of systematic review (PROSPERO) with the code CRD42024507972. Searches were conducted in databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, without imposing a time limit until February 7th, 2024. The random-effects model was employed for meta-analysis, and the I2 index was used to assess heterogeneity among studies. Finally, data analysis was performed using STATA (version 14).

RESULTS

Based on the search in different databases, a total of 4367 articles were identified. Finally, after screening, selecting, and quality evaluation of the studies, 30 studies were considered for meta-analysis in which 13,916 sonographers were examined. According to the results of the meta-analysis, the overall prevalence of MSDs among sonographers was reported as 75.80% (95% CI: 65.37-86.23, I2 = 99.7%, P < 0.001). Additionally, the prevalence rates of these disorders in the neck (63.73%), shoulder (60.13%), upper back (53.69%), lower back (49.84%), wrist (44.41%), elbow (27.46), hip (24.93%), knee (19.59), and ankle (16.92%) were determined.

CONCLUSION

Given the relatively high prevalence of MSDs among sonographers and the importance of reducing specific risk factors associated with their duties, it is recommended to consider solutions such as carrying out ergonomic assessments and interventions, as well as providing training programs and appropriate corrective exercises to mitigate MSDs among sonographers.

Dairy farm management factors associated with auction sale price of young dairy calves sold at auction markets in Québec, Canada. A cross-sectional study

Each year around 150,000 surplus calves are sold at auction markets in Québec, Canada. Surplus calves (male or female not kept in the herd of origin) are sold at a young age, but these animals are at risk of receiving lower quality neonatal care than replacement heifers. Knowledge of factors associated with a higher selling price could help convince farmers to spend more resources in the care surplus calves. Our objective was to explore the associations between farm management practices and the median percentile of surplus calf selling price per farm at auction markets. The price (CAD/kg of body weight) and the individual identification number of surplus calves sold in 2 auction markets in Québec during 4 sales days in the summer 2019 and in the winter 2020 were recorded. The recorded price of each surplus calf was transformed as percentile for each breed and day of sale. Farmers managing the surplus calves were contacted and interviewed on farm management practices. The data from farmer's interviews were analyzed as potential variables associated with the median percentile of calves' selling price per farm (farm level dependent variable) in a multivariable linear regression model. A total of 509 farmers were contacted, of which 433 farmers agreed to participate, and 409 interviews were retained for statistical analysis. The farms enrolled in the study had sold a median of 2 calves (range 1-19 calves) during the sale days considered. The main breed of surplus calves sold were Holstein (82%) and Angus crossbred calves (9%). The results from the multivariable model showed that median percentile of calves' selling price was positively associated with farms with an average milk production per cow superior to 11,000 L/years (β 0.13, 95% confidence interval (95% CI): 0.045, 0.221) and farms with 3 or more workers available to take care of surplus calves (β 0.08, 95% CI: 0.005, 0.167). Those results indicate that farms having an average milk production per cow superior to 11,000 L/year increase the calves' selling price by 13 percentiles (i.e., from 50th to 63rd) and that farms having at least 3 caretakers increase their median percentile calves' selling price by 8 percentiles (i.e., from 50th to 58th). Median percentile of calves' selling price was negatively associated with farms that vaccinated cows for neonatal calf diarrhea (β -0.06, 95% CI:-0.127, -0.011), that do not disinfect the navel of newborn calves (β -0.07, 95% CI:-0.133, -0.012), that allow transporters to enter the farm's building (β -0.07, 95% CI:-0.130, -0.015) and that used wood shaving as bedding for surplus calves (β -0.08, 95% CI:-0.156, -0.021). Sensitivity analyses performed on farms that have sold 2 or more surplus calves did not show significant changes in the associations found. Despite the fact that the study was based on self-reported questionnaire answers and a small number of calves per farm, it provides insight on farm management practices associated with median percentile of surplus calf selling price at the auction markets. Taking these results in consideration, farmers could potentially improve the market value of their animals.

Playing-related musculoskeletal disorders among Chinese conservatoire piano students: prevalence, risk factors and preventive interventions

Introduction

Both professional musicians and conservatoire students are at significant risk of developing playing-related musculoskeletal disorders (PRMDs) during their career life. With the growing number of students pursuing a conservatory degree and graduating from music conservatory in China, the aims of this study were: (1) to identify the nature of PRMD and explore the prevalence of PRMD in Chinese conservatoire students; (2) to determine the relevant risk factors with the presence of PRMD among Chinese conservatoire students; and (3) to suggest preventive interventions for young pianists at their early career stage.

Methods

A self-reported online survey study was conducted among 363 Chinese conservatoire students who majored in piano performance.

Results

Of all respondents, 82.6% reported having had at least one PRMD. The wrist was proved to be the most affected body site, followed by the shoulder, finger and arm. Respondents who experienced PRMD reported "pain," "fatigue," and "stiffness" as the most frequent symptoms. The main risk factors associated with PRMD included gender, years of playing experiences, practice hours, warm-up habits before practice, and break-taking during practice.

Discussion

Female students, those with longer year of playing experience, those who practice longer hours, those who do not warm up before practice, and those who do not take breaks during practice were found to have more PRMD symptoms and higher level of severity. This study highlights the need to increase awareness of PRMD among conservatoire students and to understand the occurrence of PRMD; it is helpful for young pianists to prevent severe musculoskeletal disorders and implement preventive measures at early career stages. Further studies are suggested to follow up on music students who have had at least one PRMD at different stages of professional musical training.

Function-based risk reduction intervention for lifestyle-related disorders among inactive 40-year-old people: a pilot randomised controlled trial

BACKGROUND

 Interventions for preventing or reducing the development of lifestyle-related disorders should be investigated as these conditions are becoming increasingly prevalent and having large effects on quality of life and life expectancy globally. The aim of this pilot study was to prepare for a full-scale randomised controlled trial by evaluating the short-term changes resulting from a function-based preventive intervention aimed at lifestyle-related disorders on a small group of physically inactive 40-year-old people. Change in objectively measured physical activity, functional capacity according to a risk profile, and goal attainment were main outcomes.

METHODS

Participants (n = 27) underwent functional examinations including tests of fitness, strength, mobility, balance, and posture as well as standard medical examinations including weight measures, blood pressure and blood tests and were randomised to two groups. The intervention group (n = 15) received feedback from all the examinations and lifestyle counselling based on a functional profile. The control group (n = 12) received feedback only from the standard medical examination. Follow-up was at 3-4 months. Changes in physical activity measured with accelerometers, functional levels on the functional profile, goal attainment and subjective assessments of health-related quality of life, motivation, function, and physical activity were examined, as were standard medical parameters.

RESULTS

Change in mean time in moderate or more intense physical activity was 9 min higher in the intervention group (95% confidence interval -6.35, 24.51) and change in sedentary time was 42 min lower (-95.24, 11.32). The intervention group showed a higher increase in motivation for change 1.58 on 10-point scale (0.20, 2.97) and indicated more improvement on the functional risk levels concerning fitness (-0.06, 0.90). Correlation between objectively measured and self-assessed physical activity and function increased after the intervention. Most participants in the intervention group achieved some or all of their goals.

CONCLUSIONS

This small-scale pilot intervention with functional examinations and lifestyle counselling showed positive tendencies for change in short-term physical activity level. It seemed to lead to better understanding of personal functional capacity and increased motivation for lifestyle changes. Setting and fulfilling meaningful goals for lifestyle-related changes seemed to influence levels on the functional profile in positive directions. Research on larger and more diverse populations will be necessary to better understand the implications of the intervention.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05535296 first posted on 10/09/2022.

Grip and pinch strength prediction models based on hand anthropometric parameters: an analytic cross-sectional study

BACKGROUND

Hand grip strength (HGS) and pinch strength are important clinical measures for assessing the hand and overall health.

OBJECTIVE

The aim of the present study is to predict HGS and pinch strength based on 1 hand anthropometry, and (2) body anthropometric parameters using machine learning.

METHODS

A Secondary analysis was conducted on 542 participant aged 30-60 years from the Persian Organizational Cohort study in Mashhad University of Medical Sciences. Artificial Neural Network (ANN) were fitted as prediction model. The dataset was divided into two sets: a training set, which comprised 70% of the data, and a test set, which comprised 30% of the data. Various combinations of the hand anthropometric, demographic, and body anthropometric parameters were used to determine the most accurate model.

RESULTS

The optimal HGS model, using the input of gender, body mass, and hand anthropometric parameters of length (both total length and palm), maximum width, maximum breadth, and hand shape index, achieved nearly equal accuracy to the model that incorporated all variables (RMSE = 5.23, Adjusted R2 = 0.67). As for pinch strength, gender, hand length (both total length and palm), maximum width, maximum breadth, hand shape index, hand span, and middle finger length came closest to the model incorporating all variables (RMSE = 1.20, Adjusted R2 = 0.52).

CONCLUSION

This ANN model showed that hand anthropometric parameters of total length, palm length, maximum width, maximum breadth, and the hand shape index, emerge as optimal predictors for both HGS and HPS. Body anthropometric factors (e.g., body mass) play roles as predictors for HGS, whereas their influence on pinch strength appears to be less pronounced.

LEVEL OF EVIDENCE

Level III (Diagnosis).

TRIAL REGISTRATION

Not applicable.

Development of a self-assessment tool to evaluate the readiness of pharmacy departments for internship training in China: a two-phase study

OBJECTIVES

Internships in the pharmacy departments of training hospitals represent a crucial stage in the professional development of pharmacy students. However, the quality of internship training varies significantly across training hospitals in China, and there is a lack of standardized readiness evaluation tools. Therefore, the purpose of this study was to develop a self-assessment tool to evaluate the preparedness of training hospitals for providing internship training.

METHODS

This study employed an exploratory mixed-methods approach and was conducted in two phases. In the first phase, during 2021, focus groups were conducted with 16 interns from three tertiary hospitals in Henan Province. In 2022, 14 preceptors from tertiary hospitals in various provinces were interviewed either one-on-one or in focus groups. The interview data were analyzed using thematic analysis to compile a set of self-assessment indicators for internship training readiness. Subsequently, the initial draft of the self-assessment tool for internship training readiness was developed by integrating the indicators derived from the interviews and literature review. In the second phase, the Delphi method was utilized. In 2023, the experts participated in two rounds of correspondence (21 experts in the first round and 19 in the second round), and consensus was reached on the indicators of the self-assessment tool after the two rounds. Meanwhile, these experts assessed the current status of internship training in training hospitals across China.

RESULTS

The qualitative findings of the first phase included five themes and 22 sub-themes, which were integrated with the indicators derived from the literature review to develop an initial indicator framework for the second phase. This initial framework comprised five domains and 37 items. The second phase involved two rounds of expert surveys, with effective response rates of 90.48% and 89.47%, respectively. Ultimately, the self-assessment tool for evaluating the readiness of pharmacy departments in training hospitals for internships included five dimensions and 35 secondary indicators: (1) organizational structure, (2) training content, (3) training mode, (4) effectiveness evaluation, and (5) emergency management. Additionally, experts assessed the readiness of pharmacy departments in Chinese training hospitals for internships, yielding varied results. Emergency management preparedness scored the highest, followed by organizational structure and training content preparation. However, the modes of internship training and the evaluation of training effectiveness received lower scores.

CONCLUSION

The developed tool provides a comprehensive self-assessment checklist for the pharmacy departments of training hospitals and possesses the potential to enhance the development of more effective internship training programs.

Rejected sickness cash benefit claims after 180 days of sick leave in the Swedish rehabilitation chain: A nationwide register-based study

AIM

Since a lack of financial security among vulnerable groups could further hamper health and well-being, this study scrutinises factors predicting rejected prolonged sickness cash benefit claims among people on compensated sick leave of more than 180 days with a rejection between days 181 and 365.

METHODS

All 246,872 claims for employed people on sick leave recorded in the Swedish official statistics register between January 2018 and June 2021 were analysed. Claim outcome was evaluated using logistic regression with odds ratios recalculated to relative risks (RR) with 95% confidence intervals (CI), mutually adjusted for sociodemographic, work and health-related factors.

RESULTS

Overall, 46,611 (19%) of the claims were rejected, with slightly lower rates among women (RR=0.97; 95% CI 0.95-0.99). Musculoskeletal diseases had the highest rejection rates (RR=1.84; 95% CI 1.75-1.94) followed by injuries (RR=1.57; 95% CI 1.50-1.64) and symptoms (RR=1.51; 95% CI 1.46-1.56). Mental disorders also had above-average rates (RR=1.14; 95% CI 1.09-1.19), whereas the lowest rates were found among pregnancy-related diagnoses (RR=0.13; 95% CI 0.12-0.14) and neoplasms (RR=0.18; 95% CI 0.18-0.18). Higher rates were found among immigrants (RR=1.37; 95% CI 1.34-1.40), those with only primary education (RR=1.09; 95% CI 1.06-1.12) and among blue-collar workers. The regional variation was substantial (RR range 0.41-1.72).

CONCLUSIONS

High rejection rates were found for complex diagnoses and diagnoses with presupposed work ability in physically lighter occupations and among groups with assumed precarious positions at the labour market. Systematic differences in rates were identified between geographic regions. More studies are warranted to conclude if the differences found could be justified by other factors.

Retrospective quality review of Department of Transportation (DOT) commercial drivers medical examination forms

OBJECTIVE

This study aimed to evaluate the quality of completion among both drivers and medical examiners in filling out Commercial Driver's (CD) Medical Examination Report Forms.

METHODS

This was a cross-sectional retrospective study of abstracted data from the year 2019. CD Medical Examination Report Forms, collected from a single nationally-based employer and initially reviewed by corporate medical directors, were evaluated by the study team for completeness of documentation provided by both drivers and medical examiners (MEs). Relevant findings included unanswered questions, inconsistency between responses, and lack of necessary elaboration for positive responses.

RESULTS

Among 1603 examinations, MEs completed the Medical Examination Report Form incompletely or incorrectly in 30% of examinations (n = 484). Drivers inconsistently filled out their health history with elaborations 38.7% of the time. Most commonly, they failed to elaborate on positive health history responses in 28.7% of examinations, but other types of errors were noted as well.

CONCLUSIONS

A considerable proportion of drivers or examiners (n = 890, 55%) failed to adequately or correctly complete CD Medical Examination Report forms.

Occupational accidents in mining workers: scoping review of studies published in the last 13 years

OBJECTIVE

Mining activity represents one of the most hazardous occupations related to health, with 8% of fatal injuries concentrated in this sector worldwide. Thus, it is crucial to timely identify the factors involved in such injuries. We aimed to explore the sociodemographic and occupational/organisational factors associated with injuries, causative agents and subsequent disabilities and fatality of workers exposed to occupational injuries in the mining sector.

DESIGN

A secondary scoping review was conducted following the Joanna Briggs Institute guidelines.

DATA SOURCES

Scopus, Embase, Virtual Health Library, SciELO and PubMed databases were searched in February 2022 and updated in October 2023. The protocol was developed in April 2022.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

We included observational studies published within the last 13 years (2010-2022) which provided information on injuries of the mining workers and reported associated factors as well as health consequences.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers examined the eligibility criteria, screened and coded the extracted information using prevalidated data extraction tools, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews reporting guidelines.

RESULTS

A total of 123 studies were found, of which nine were selected for inclusion in this review. Participants were between 15 and 80 years old, and the rate of injuries ranged from 4.4% to 10.6% of reported cases. Among the total selected studies, mechanical agents were identified as the leading cause of injuries in six studies. The factors associated with injuries included age, gender (female) and biochemical characteristics. On the other hand, occupational and organisational factors encompassed work shift, outsourcing (contractors) and less than 2 years of experience in the sector.

CONCLUSION

This review emphasises that both work-related and individual characteristics are significantly related factors of injuries. Moreover, commonly reported health consequences of injuries encompass mortality, average days lost and permanent, partial or total disability.

Risk Factors for Musculoskeletal Disorders in Korean Farmers: Survey on Occupational Diseases in 2020 and 2022

BACKGROUND/OBJECTIVES

This study investigated factors influencing the prevalence of musculoskeletal disorders (MSDs) resulting from agricultural work, utilizing the 2020 and 2022 occupational disease survey data collected by the Rural Development Administration. The combined data from these years indicated a 6.02% prevalence of MSDs, reflecting a significant class imbalance in the binary response variables. This imbalance could lead to classifiers overlooking rare events, potentially inflating accuracy assessments.

METHODS

We evaluated five distinct models to compare their performance using both original and synthetic data and assessing the models' performance based on synthetic data generation. In the multivariate logistic model, we focused on the main effects of the covariates as there were no statistically significant second-order interactions.

RESULTS

Focusing on the random over-sampling examples (ROSE) method, gender, age, and pesticide use were particularly impactful. The odds of experiencing MSDs were 1.29 times higher for females than males. The odds increased with age: 2.66 times higher for those aged 50-59, 4.60 times higher for those aged 60-69, and 7.16 times higher for those aged 70 or older, compared to those under 50. Pesticide use was associated with 1.26 times higher odds of developing MSDs. Among body part usage variables, all except wrists and knees were significant. Farmers who frequently used their necks, arms, and waist showed 1.27, 1.11, and 1.23 times higher odds of developing MSDs, respectively.

CONCLUSIONS

The accuracy of the raw method was high, but the ROSE method outperformed it for precision and F1 score, and both methods showed similar AUC.