The work stress, occupational burnout, coping strategies and organizational support of elite sports coaches in Sichuan Province: the mediating role of organizational support

Objective

This study investigated the relationships between job pressure, occupational burnout, organizational support and coping strategies among competitive sports coaches in Sichuan Province, China. It also assesses the impact of job pressure on occupational burnout and the mediating roles of organizational support and coping strategies.

Methods

A survey was conducted with 207 competitive sports coaches from Sichuan Province, China. Basic information and data on job pressure, occupational burnout, organizational support and coping strategies were collected. Correlations between variables were analyzed, and a theoretical model for hypothesizing the mediating effects was established. A multiple regression model was used to predict the relationships between occupational burnout and job pressure, organizational support and coping strategies.

Results

(1) Job pressure was significantly positively correlated with occupational burnout (R = 0.436, p < 0.001) and negative coping (R = 0.389, p < 0.001) but significantly negatively correlated with organizational support (R = -0.503, p < 0.001). Occupational burnout was significantly negatively correlated with academic title (R = -0.158, p = 0.023) and organizational support (R = -0.349, p < 0.001) but significantly positively correlated with negative coping (R = 0.440, p < 0.001). Organisational support was significantly positively correlated with positive coping (R = 0.222, p = 0.001) but significantly negatively correlated with negative coping (R = -0.207, p = 0.003). (2) Mediating effects: Job pressure indirectly affects occupational burnout via organizational support and negative coping strategies. (3) Multiple regression: Y1 (Job Pressure) = 69.262 + 1.172 × Emotional Exhaustion -2.231 × Emotional Support +1.041 × Negative Coping -6.554 × Academic Title (from high to low). Y2 (Occupational Burnout) = 25.609 + 0.141 × Job Pressure - 0.306 × Organisational Support +0.620 × Negative Coping -2.097 × Academic Title.

Conclusion

Job pressure is a significant factor leading to occupational burnout among competitive sports coaches in Sichuan Province, China, and factors such as role, interpersonal relationships and career development are closely related to occupational burnout. The sense of organizational support and negative coping strategies play a mediating role between job pressure and occupational burnout. Reducing emotional exhaustion and negative coping, enhancing emotional support and improving the academic titles of coaches can help to reduce job pressure and occupational burnout among competitive sports coaches in Sichuan Province.

Well-being among university students in the post-COVID-19 era: a cross-country survey

University students have to handle crucial challenges for their future lives, such as succeeding in academic studies and finding attachment figures. These processes could potentially involve their well-being and mental health, with possible sociocultural differences based on the country of study. In order to explore such potential differences, a cross-sectional, multi-center survey was performed involving students from the University of Torino (Italy), Sevilla (Spain), and Lusòfona (Portugal). The survey, conducted from May to November 2023, investigated students' demographic and educational details, socioeconomic status, social support, mental health, academic environment, perceived COVID-19 pandemic impact, and future plans. Demographic profiles showed a predominance of female participants and straight sexual orientation, followed by bisexuality. Italian students showed the lowest levels of mental well-being and the highest rates of mental problems (anxiety and depression) and suicidal risk across the three countries despite the relatively similar profiles of social support. The prevalence of the students' confidence in their professional future is higher in Spain than in Italy and Portugal. This study provides a comprehensive examination of university students' mental health and well-being in three Southern European countries, addressing the major mental health challenges among university students and offering valuable insights for public health purposes.

Sleep disturbances and psychological well-being among military medical doctors of the Swiss Armed Forces: study protocol, rationale and development of a cross-sectional and longitudinal interventional study

Background

Compared to civilians and non-medical personnel, military medical doctors are at increased risk for sleep disturbances and impaired psychological well-being. Despite their responsibility and workload, no research has examined sleep disturbances and psychological well-being among the medical doctors (MDs) of the Swiss Armed Forces (SAF). Thus, the aims of the proposed study are (1) to conduct a cross-sectional study (labeled 'Survey-Study 1') of sleep disturbances and psychological well-being among MDs of the SAF; (2) to identify MDs who report sleep disturbances (insomnia severity index >8), along with low psychological well-being such as symptoms of depression, anxiety and stress, but also emotion regulation, concentration, social life, strengths and difficulties, and mental toughness both in the private/professional and military context and (3) to offer those MDs with sleep disturbances an evidence-based and standardized online interventional group program of cognitive behavioral therapy for insomnia (eCBTi) over a time lapse of 6 weeks (labeled 'Intervention-Study 2').

Method

All MDs serving in the SAF (N = 480) will be contacted via the SAF-secured communication system to participate in a cross-sectional survey of sleep disturbances and psychological well-being ('Survey-Study 1'). Those who consent will be provided a link to a secure online survey that assesses sleep disturbances and psychological well-being (depression, anxiety, stress, coping), including current working conditions, job-related quality of life, mental toughness, social context, family/couple functioning, substance use, and physical activity patterns. Baseline data will be screened to identify those MDs who report sleep disturbances (insomnia severity index >8); they will be re-contacted, consented, and randomly assigned either to the eCBTi or the active control condition (ACC) ('Intervention-Study 2'). Individuals in the intervention condition will participate in an online standardized and evidence-based group intervention program of cognitive behavioral therapy for insomnia (eCBTi; once the week for six consecutive weeks; 60-70 min duration/session). Participants in the ACC will participate in an online group counseling (once the week for six consecutive weeks; 60-70 min duration/session), though, the ACC is not intended as a bona fide psychotherapeutic intervention. At the beginning of the intervention (baseline), at week 3, and at week 6 (post-intervention) participants complete a series of self-rating questionnaires as for the Survey-Study 1, though with additional questionnaires covering sleep-related cognitions, experiential avoidance, and dimensions of self-awareness.

Expected outcomes

Survey-Study 1: We expect to describe the prevalence rates of, and the associations between sleep disturbances (insomnia (sleep quality); sleep onset latency (SOL); awakenings after sleep onset (WASO)) and psychological well-being among MDs of the SAF; we further expect to identify specific dimensions of psychological well-being, which might be rather associated or non-associated with sleep disturbances.Intervention-Study 2: We expect several significant condition-by-time-interactions. Such that participants in the eCBTi will report significantly greater improvement in sleep disturbances, symptoms of depression, anxiety, stress reduction both at work and at home (family related stress), and an improvement in the overall quality of life as compared to the ACC over the period of the study.

Conclusion

The study offers the opportunity to understand the prevalence of sleep disturbances, including factors of psychological well-being among MDs of the SAF. Further, based on the results of the Intervention-Study 2, and if supported, eCBTi may be a promising method to address sleep disturbances and psychological well-being among the specific context of MDs in the SAF.

"PTSD symptoms among patients with multiple sclerosis in Jordan during October 7th gaza war outbreak"

OBJECTIVE

Clinicians have noted that the ongoing war on Gaza has had a psychological impact on people with multiple sclerosis (PwMS) whose mental health is particularly vulnerable during times such as these. The present study sought to examine the prevalence and correlates of posttraumatic stress disorder (PTSD) symptoms among PwMS in Jordan during the Gaza war outbreak.

METHODS

This was a cross-sectional study involving 171 patients (PwMS) out of 372 patients approached (46% response rate) who were being seen in the MS unit at Al Bashir Hospital, Ammann, Jordan. Inclusion criteria required that participants had been following daily news updates of the October 7 war in Gaza for the past 4 months.

RESULTS

Of participants, 125 (73.1%) were female, 98 (57.3%) were on therapy for less than five years, and 30 (17.5%) reported having a relapse during the past 6 months. Significant PTSD symptoms were identified in 58.5% (100 of 171 participants). Those at higher risk were the unemployed (OR = 2.14, 95% CI = 1.13-4.07, P = 0.02), whereas patients receiving dimethyl fumarate (19.9%) were at lower risk (OR = 0.43, 95% CI = 0.19-0.94, P = 0.02).

CONCLUSION

The high rate of significant PTSD symptoms among people with MS in this study underscores the need for attention by primary care providers and implementation of a comprehensive multidisciplinary approach to optimize the mental well-being of this fragile population.

Influence of extended working hours and physical recovery on absenteeism in the footwear industry from a system dynamics model

Objectives. Work-related musculoskeletal disorders (WMSDs) are recurrent in the footwear industry, resulting in absenteeism. This study aimed to quantitatively analyze the influence of overtime work and physical recovery time on the occurrence of WMSD-related absenteeism using a system dynamics model. As ergonomic methods have limitations in quantitatively simulating the behavior of these relationships, the integration of computational modeling techniques has emerged as a methodological alternative to bridge this gap. Methods. An ergonomic work analysis (EWA) was developed in a production cell of a large company. A model of causal relationships (causal loop diagram) and a simulation model (flow and stock diagram) were then developed, where three scenarios for overtime and physical recovery time were analyzed. Results. Working an additional hour resulted in a 42% increase in physical overload, leading to 7.62 leave requests per year and 78.7 days of employee absenteeism. Increasing the physical recovery time by 15 min reduced the overload to 36.5%, resulting in 6.8 leave requests per year and 71.1 days of employee absenteeism. Conclusions. Properly managing excess workload and providing adequate physical recovery for professionals is necessary to mitigate the productivity impacts of absenteeism in the footwear industry.

Evaluation of postgraduate foundation training for dental therapists: does participation enhance career prospects?

Objectives This study explored the value of dental therapy foundation training (DTFT) in the UK and how participation influenced career prospects.Aims To examine the efficacy of postgraduate foundation training for dental therapists (DTs) and evaluate whether participation increased clinical confidence. To investigate whether participation in the scheme enhanced career prospects and to determine barriers encountered by DTs in securing suitable positions, inclusive of COVID-19 restrictions.Methods The study used a survey incorporating open, closed, Likert-scale and multiple-choice questions. Quantitative data were analysed with IBM SPSS Statistics v26. Analysis of qualitative data was undertaken by two researchers. Final themes and subthemes were confirmed following round table discussions.Results A total of 94 survey responses were received: 61 from DTs who had not undertaken DTFT (Group A) and 33 who had undertaken DTFT (Group B). Most respondents were female (95%) with a mean age of 33.8 and 32.9 years, respectively. In total, 58.3% of Group A respondents did not believe that completing DTFT would have enhanced their career prospects, whereas 63.6% of Group B said that they gained a position as a result of completing DTFT. Participation in DTFT increased perceived clinical confidence in Group B and 81.8% were likely to recommend DTFT to their peers. A total of 12 major themes and 13 subthemes were identified.Conclusions DTFT schemes were considered a valuable educational experience which increased clinical confidence. Participation may have enhanced career prospects. Barriers were encountered by DTs when seeking work, regardless of participation in DTFT.

Enhancing physiotherapy department design to prevent work-related musculoskeletal disorders: Vision of future research

BACKGROUND

The increasing prevalence of work-related musculoskeletal disorders (WRMSDs) necessitates a reevaluation of physiotherapy department design. Optimizing these spaces is crucial as they serve as primary settings for preventing and managing WRMSDs, highlighting the need for a forward-thinking approach.

OBJECTIVE

This study aims to outline a vision for future research by identifying key strategies to prevent WRMSDs and enhance operational efficiency in physiotherapy departments.

METHODS

Ergonomics, workplace safety, and physiotherapy practices formed the basis for this paper in identifying the current challenges and opportunities in departmental design. Expert insights and feedback from healthcare practitioners aiding in the formulation of innovative solutions and recommendations for future research endeavors.

RESULTS

Integration of ergonomic principles, advanced technologies, interdisciplinary collaboration, and proactive safety measures into physiotherapy department design improve working environments for physiotherapists.

CONCLUSION

Envisioning the future of physiotherapy department design offers promising avenues for improving patient care outcomes and supporting therapist well-being.

Longitudinal Changes in Dietary Supplement Use among United States Military Personnel: The US Military Dietary Supplement Use Study

Previous studies investigating temporal changes in dietary supplement (DS) use have used representative samples but have not followed the same cohort over time. This study investigated longitudinal patterns of changes in DS use and factors associated with discontinuing DS use in a single group of active-duty United States military service members (SMs). SMs (n = 5778) completed two identical questionnaires on their DS use and demographic/lifestyle characteristics an average ± standard deviation 1.3 ± 0.2 years apart. Prevalences of reported DS use ≥1 times/week in the baseline (BL) and follow-up (FU) phases were: any DS, BL = 77%, FU = 78%; multivitamins/multiminerals (MVM), BL = 50%, FU = 48%; individual vitamins/minerals, BL = 33%, FU 35%; proteins/amino acids, BL = 43%, FU = 39%; combination products, BL = 44%, FU = 37%; prohormones, BL = 5%, FU = 4%; herbal products, BL = 23%, FU = 21%; joint health products, BL = 12%, FU = 12%; fish oils, BL = 25%, FU = 23%; other DSs, BL = 17%, FU = 17%. Among BL users, the proportions reporting use in the FU phase were: any DS 88%, MVM 74%, protein/amino acids 70%, individual vitamin/minerals 62%, combination products 62%, fish oils 61%, joint health products 57%, herbal products 50%, other DSs 50%, and prohormones 37%. Higher odds of discontinuing any DS use in the follow-up were associated with female gender, younger age, higher BMI, and less weekly resistance training. Overall, prevalence of DS use was relatively consistent in the two phases; however, the cohort changed their use patterns in the follow-up with some discontinuing use and others initiating use, thus maintaining use prevalence over the period. These findings have implications for repeated cross-sectional DS studies where different samples are followed over time.

Exploring the gender-sensitive feelings of nurses towards residents with intimate and sexual needs in dementia nursing care

INTRODUCTION

Person-centered care emphasizes close care relations regardless of gender. However, when residents with dementia express intimate or sexual needs, nurses may struggle with their own emotions and need to include personal boundaries.

METHODS

277 (vocational) nurses from 25 Dutch nursing homes completed a survey, including the Feeling Word Checklist for a resident with perceived sexual needs and another for a resident with perceived intimate needs.

RESULTS

Positive-nurturing sentiments towards residents prevail, yet residents expressing intimate needs elicit higher levels of positive-nurturing and lower levels of negative emotions than those with sexual needs. Male residents, who expressed more pronounced sexual needs, received less affection and interest from female nurses who felt especially close to female residents with intimate needs.

CONCLUSION

Close care relations established through nurses' personal emotions inadvertently introduce gender-sensitive and differing emotions towards residents. Nurses' capability to include personal boundaries benefits the relationship and well-being of both parties.

Global burden of HIV among long-distance truck drivers: a systematic review and meta-analysis

OBJECTIVES

The purpose of this study was to systematically summarise the empirical evidence on the prevalence of HIV among long-distance truck drivers (LDTDs) from all parts of the world.

DESIGN

A systematic review and meta-analysis were conducted.

DATA SOURCES

We searched PubMed, ProQuest Central, PubMed Central, Cumulated Index to Nursing and Allied Health Literature and Global Index Medicus to identify relevant information published from 1989 to 16 May 2023.

ELIGIBILITY CRITERIA

Peer-reviewed publications of English language reporting on the prevalence of HIV among LDTDs were included. Non-empirical studies like literature reviews were excluded.

DATA EXTRACTION AND SYNTHESIS

Using a standardised data abstraction form, we extracted information on study characteristics and HIV prevalence levels. Crude prevalence estimates per 100 participants were computed and later transformed using logit transformation to have them follow a normal distribution. A meta-analysis of prevalences using the random effects model was performed. The I2 statistic was used to quantify the degree of heterogeneity across studies. A subgroup analysis using meta-regression was performed to investigate factors that could explain variability across studies. The Joanna Briggs Institute tools and Newcastle-Ottawa Scale were used to assess the quality of the included studies. To assess the certainty of evidence, the Grading of Recommendations Assessment, Development, and Evaluation approach was used.

RESULTS

Of the 1787 articles identified, 42 were included. Most of the included studies were conducted in sub-Saharan Africa (45.23%, n=19) and Asia and the Pacific (35.71%, n=15). The pooled prevalence of HIV was 3.86%, 95% CI (2.22% to 6.64%). The burden of HIV was highest in sub-Saharan Africa at 14.34%, 95% CI (9.94% to 20.26%), followed by Asia and the Pacific at 2.12%, 95 CI (0.94% to 4.7%) and lastly Western, Central Europe and North America at 0.17%, 95% CI (0.03% to 0.82%). The overall heterogeneity score was (I2=98.2%, p<0.001).

CONCLUSION

The global burden of HIV among LDTDs is 3.86%, six times higher than that of the general population globally. Compared with other regions, the burden of HIV is highest in sub-Saharan Africa at 14.34%, where it is estimated to be 3% in the general population. Thus, LDTDs endure a disproportionately high burden of HIV compared with other populations. Consequently, more LDTD-centred HIV research and surveillance is needed at national and regional levels to institute tailored preventive policies and interventions.

PROSPERO REGISTRATION NUMBER

CRD42023429390.

Axiomatic design for safe construction considering lean and ergonomic principles: an application in Turkey

This study proposes a systematic approach based on axiomatic design incorporating lean and ergonomic principles within the proposed design. The contribution to the body of knowledge is to keep construction workers safe by fostering a secure construction environment. Axiomatic design and lean approaches are combined to address human factors and eliminate wastes that hinder a safe construction environment. The application of the proposed system is set in the context of the construction industry. The methodology provides the construction sector with a road map toward reducing the occurrence of accidents and serves as a complementary approach between lean and ergonomic principles. The design solution has been validated and partially applied in a metro construction firm. Results show that the design solution can improve the efficiency of the construction phases by adopting a value-maximization strategy and has the potential to improve the safety and ergonomics of construction projects.

Nurse burnout: deep connections and solutions revealed by network analysis

BACKGROUND

Burnout is very important to nurses' physical and mental health and career development. Current approaches to assessing nurse burnout tend to use a total score modeling paradigm to explore the impact of external factors on burnout. The purpose of this study is to delve into the item-level relationship between nurse burnout and its influencing factors at both the social and psychological levels using a network analysis approach.

METHODS

This study was conducted in June 2023 and 1,005 nurses from 4 hospitals out of 8 tertiary care hospitals in Harbin were selected to participate in this study using whole cluster sampling method. Measurements included a general demographic questionnaire, Trait coping styles questionnaire, Organizational commitment questionnaire, Work-family conflict scale, Transformational leadership questionnaire, and Maslach Burnout Inventory-General Survey.

RESULTS

Our results suggest that "C1 Time-Based work interference with family" showed the strongest centrality and bridging in the overall network. This finding underscores its centrality to burnout. Other strongest bridge symptoms included "E2 Reduced personal accomplishment" and "A1 Positive coping styles" indicating their strongest connections to other clusters.

CONCLUSIONS

Nurse administrators should be encouraged to pay more attention to nurses' work situations and family distress, and to help nurses in a flexible way.

Caring for those who care: key challenges and improvement opportunities for health professionals working with children with disabilities

This paper investigates the challenges faced by health professionals working with children with disabilities, with the aim of identifying areas for improvement. Employing a focus group method, the study involved knowledge levelling, discussions, problematization, cause formulation, and validation. A diverse team of ten professionals participated, including physiotherapists, speech therapists, occupational therapists, psychologists, nursing technicians, and social workers. Findings reveal organisational inflexibility in appointment scheduling, lack of deadlines affecting case monitoring, and the mental strain of immediate clinical responses. Effective communication and multidisciplinary care emerge as beneficial. Proposed improvements include flexible space utilisation, enhanced room design, structured collaboration training, role clarification, parent partnerships, flexible scheduling, and continuous professional development. This study unveils unique challenges and rewards in the healthcare environment, offering insights into causative factors and practical strategies for enhancing the work of health professionals working with children with disabilities.

Deciphering Optimal Radar Ensemble for Advancing Sleep Posture Prediction through Multiview Convolutional Neural Network (MVCNN) Approach Using Spatial Radio Echo Map (SREM)

Assessing sleep posture, a critical component in sleep tests, is crucial for understanding an individual's sleep quality and identifying potential sleep disorders. However, monitoring sleep posture has traditionally posed significant challenges due to factors such as low light conditions and obstructions like blankets. The use of radar technolsogy could be a potential solution. The objective of this study is to identify the optimal quantity and placement of radar sensors to achieve accurate sleep posture estimation. We invited 70 participants to assume nine different sleep postures under blankets of varying thicknesses. This was conducted in a setting equipped with a baseline of eight radars-three positioned at the headboard and five along the side. We proposed a novel technique for generating radar maps, Spatial Radio Echo Map (SREM), designed specifically for data fusion across multiple radars. Sleep posture estimation was conducted using a Multiview Convolutional Neural Network (MVCNN), which serves as the overarching framework for the comparative evaluation of various deep feature extractors, including ResNet-50, EfficientNet-50, DenseNet-121, PHResNet-50, Attention-50, and Swin Transformer. Among these, DenseNet-121 achieved the highest accuracy, scoring 0.534 and 0.804 for nine-class coarse- and four-class fine-grained classification, respectively. This led to further analysis on the optimal ensemble of radars. For the radars positioned at the head, a single left-located radar proved both essential and sufficient, achieving an accuracy of 0.809. When only one central head radar was used, omitting the central side radar and retaining only the three upper-body radars resulted in accuracies of 0.779 and 0.753, respectively. This study established the foundation for determining the optimal sensor configuration in this application, while also exploring the trade-offs between accuracy and the use of fewer sensors.

[Interdisciplinary, collaborative D-A-CH (Germany, Austria and Switzerland) consensus statement concerning the diagnostic and treatment of myalgic encephalomyelitis/chronic fatigue syndrome]

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, chronic multisystemic disease which, depending on its severity, can lead to considerable physical and cognitive impairment, loss of ability to work and the need for nursing care including artificial nutrition and, in very severe cases, even death.The aim of this D-A-CH (Germany, Austria, Switzerland) consensus statement is 1) to summarize the current state of knowledge on ME/CFS, 2) to highlight the Canadian Consensus Criteria (CCC) as clinical criteria for diagnostics with a focus on the leading symptom post-exertional malaise (PEM) and 3) to provide an overview of current options and possible future developments, particularly with regard to diagnostics and therapy. The D-A-CH consensus statement is intended to support physicians, therapists and valuer in diagnosing patients with suspected ME/CFS by means of adequate anamnesis and clinical-physical examinations as well as the recommended clinical CCC, using the questionnaires and other examination methods presented. The overview of the two pillars of therapy for ME/CFS, pacing and symptom-relieving therapy options, is intended not only to provide orientation for physicians and therapists, but also to support decision-makers from healthcare policy and insurance companies in determining which therapy options should already be reimbursable by them at this point in time for the indication ME/CFS.

Ergonomic considerations for unique surgeon populations

PURPOSE OF REVIEW

Surgeons are rapidly diversifying as a population, introducing new ergonomic challenges. This review describes the challenges that are experienced by special populations of surgeons including small-handed surgeons, pregnant surgeons, and trainees, and evidence-based solutions to overcome them.

RECENT FINDINGS

Small-handed and female surgeons report more musculoskeletal complaints compared with their male counterparts. Pregnant surgeons frequently report development or worsening of musculoskeletal disorders such as carpal tunnel syndrome and low back pain. Trainees also report high rates of musculoskeletal complaints with minimal autonomy to alter their environment. Limited objective data exists regarding the ideal instruments currently available for special populations. Several small, randomized studies have proposed exercise regimens targeting the upper extremities and pregnancy-related pain syndromes with improvements in symptoms. Various methods of ergonomic education have been studied in trainees with improvements in operating room posture and performance.

SUMMARY

Limited objective data is available to recommend specific surgical instruments for high-risk surgeon populations. Beneficial exercise regimens have been described for musculoskeletal disorders commonly plaguing surgeons but have yet to be studied explicitly in small-handed or pregnant surgeons and trainees.

Drug Burden Index Is a Modifiable Predictor of 30-Day Hospitalization in Community-Dwelling Older Adults With Complex Care Needs: Machine Learning Analysis of InterRAI Data

BACKGROUND

Older adults (≥65 years) account for a disproportionately high proportion of hospitalization and in-hospital mortality, some of which may be avoidable. Although machine learning (ML) models have already been built and validated for predicting hospitalization and mortality, there remains a significant need to optimize ML models further. Accurately predicting hospitalization may tremendously affect the clinical care of older adults as preventative measures can be implemented to improve clinical outcomes for the patient.

METHODS

In this retrospective cohort study, a data set of 14 198 community-dwelling older adults (≥65 years) with complex care needs from the International Resident Assessment Instrument-Home Care database was used to develop and optimize 3 ML models to predict 30-day hospitalization. The models developed and optimized were Random Forest (RF), XGBoost (XGB), and Logistic Regression (LR). Variable importance plots were generated for all 3 models to identify key predictors of 30-day hospitalization.

RESULTS

The area under the receiver-operating characteristics curve for the RF, XGB, and LR models were 0.97, 0.90, and 0.72, respectively. Variable importance plots identified the Drug Burden Index and alcohol consumption as important, immediately potentially modifiable variables in predicting 30-day hospitalization.

CONCLUSIONS

Identifying immediately potentially modifiable risk factors such as the Drug Burden Index and alcohol consumption is of high clinical relevance. If clinicians can influence these variables, they could proactively lower the risk of 30-day hospitalization. ML holds promise to improve the clinical care of older adults. It is crucial that these models undergo extensive validation through large-scale clinical studies before being utilized in the clinical setting.

Innovative Strategies for Addressing Adolescent Health in Primary Care Through Telehealth

With recent gains in telehealth access across health sectors, this editorial explores adolescent-specific health issues where innovative use of virtual care is improving outcomes and access for adolescents. These include contraception, obesity, gender-affirming care, mental health, and eating disorder care. Clinicians caring for adolescents should be aware of advances in this field to maximize opportunities for their patients to receive evidence-based care in a manner that supports health equity and confidentiality concerns while understanding the evolving regulatory landscape of telehealth.

Being in a meaningful context. Nature and animal-assisted activities as perceived by adults with autism

INTRODUCTION

Animal-assisted and nature-based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal-assisted and nature-based activities on a farm as a complementary intervention for young adults with autism and social withdrawal.

METHODS

The participants were aged 18-30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12-week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants' characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis.

CONSUMER AND COMMUNITY INVOLVEMENT

The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective.

FINDINGS

The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants' experiences from the activity generated three categories, "Being in a meaningful context", "Creating a comfort zone" and "Developing structure in everyday life", and each of these included sub-categories.

CONCLUSION

The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non-verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention's timeframe of 12 weeks was experienced as too short for long-lasting change.

Surveillance of Health Care-Associated Violence Using Natural Language Processing

BACKGROUND AND OBJECTIVES

Patient and family violent outbursts toward staff, caregivers, or through self-harm, have increased during the ongoing behavioral health crisis. These health care-associated violence (HAV) episodes are likely under-reported. We sought to assess the feasibility of using nursing notes to identify under-reported HAV episodes.

METHODS

We extracted nursing notes across inpatient units at 2 hospitals for 2019: a pediatric tertiary care center and a community-based hospital. We used a workflow for narrative data processing using a natural language processing (NLP) assisted manual review process performed by domain experts (a nurse and a physician). We trained the NLP models on the tertiary care center data and validated it on the community hospital data. Finally, we applied these surveillance methods to real-time data for 2022 to assess reporting completeness of new cases.

RESULTS

We used 70 981 notes from the tertiary care center for model building and internal validation and 19 332 notes from the community hospital for external validation. The final community hospital model sensitivity was 96.8% (95% CI 90.6% to 100%) and a specificity of 47.1% (39.6% to 54.6%) compared with manual review. We identified 31 HAV episodes in July to December 2022, of which 26 were reportable in accordance with the hospital internal criteria. Only 7 of 26 cases were reported by employees using the self-reporting system, all of which were identified by our surveillance process.

CONCLUSIONS

NLP-assisted review is a feasible method for surveillance of under-reported HAV episodes, with implementation and usability that can be achieved even at a low information technology-resourced hospital setting.

People-Oriented Culture and Its Association With Burnout, Depressive Symptoms, and Sleep Problems During COVID-19 Pandemic Among EMS Providers in Korea

OBJECTIVE

This study examined how perceived people-oriented culture (POC) was associated with burnout, depressive symptoms, and sleep problems during the COVID-19 pandemic among emergency medical service (EMS) providers in Korea.

METHODS

We conducted a cross-sectional survey among 693 EMS providers in 2021.

RESULTS

Overall, prevalence of personal burnout, work-related burnout, and citizen-related burnout were 61.5%, 60.0%, and 60.6%, respectively. Prevalence of depressive symptoms was 25.1%. Prevalence of poor sleep quality, unrestful sleep, and sleep disturbance were 46.5%, 58.2%, and 52.2%, respectively. Compared to high POC group, higher prevalence of depressive symptoms was observed among medium (prevalence ratio: 1.57, 95% CI: 1.06, 2.32) and low (prevalence ratio: 2.70, 95% CI: 1.92, 3.79) POC group. Similar trends were observed in the analysis of burnout and sleep problems.

CONCLUSIONS

Our findings underscore that low POC could play a critical role in worsening burnout, depressive symptoms, and sleep problems among EMS providers.

A 7-Month Multidisciplinary Healthy Lifestyle Intervention Effectively Improved Cardiometabolic Risk Profile of Firefighters

OBJECTIVE

We investigated the effect of a 7-month healthy lifestyle intervention on cardiometabolic risk factors (CMRF) among male career military firefighters (FFs).

METHODS

Forty-nine FFs participated in a 7-month workplace multiddisciplinary healthy lifestyle intervention designed to reduce CMRF through exercise, diet, and improved sleep. Medical assessments, accelerometry, and surveys at the beginning and end determined program effectiveness.

RESULTS

At the end of the intervention period, there was a significant improvement in measures of body composition and blood glucose. The prevalence of hypertension also decreased significantly ( P < 0.01). The 57% of participants who fully adhered to the program had significantly greater improvements across multiple CMRF. Participants increased their physical activity and improved their diet following the intervention.

CONCLUSIONS

This healthy lifestyle intervention was effective in changing behavior and lowering cardiometabolic risk among FFs.

Implementing Indicators and Trajectories of Return to Work After Breast Cancer Diagnosis: A Mixed-Methods Study Using the French National Healthcare Insurance Database and Stakeholder Consultation

PURPOSE

Return to work (RTW) is important for quality of life after breast cancer but its analysis at the population-level remains limited in France. This study aimed to implement Electronic Healthcare Data (EHD)-based indicators and trajectories to measure RTW after breast cancer diagnosis, and to examine stakeholders' perspectives regarding these indicators.

METHODS

We followed a mixed-methods approach that consisted of (i) implementing RTW indicators and identifying clusters of trajectories using state sequence analysis with data from a representative sample of the French National Health Data System and (ii) exploring, through qualitative focus group and interviews, stakeholders' perceptions on the interpretation, limitations, and utility of these indicators.

RESULTS

We extracted data from 317 women aged 25-55 years with a first diagnosis of early-stage breast cancer. The median number of sickness absence periods was 2 for a total of 434 days during the 3-year follow-up, and the median time to sustainable RTW was 240 days. Three clusters of RTW trajectories were identified: "early RTW" (49.5% of the population), "RTW after partial resumption" (37.5%) and "continuous compensation" (12.9%). Feedback from stakeholders highlighted the multi-factorial nature of RTW and underscored the added value of EHD for studying RTW, despite certain limitations.

CONCLUSIONS

We demonstrated the feasibility of calculating RTW indicators and identifying trajectories using the French National Health Data System. These indicators can serve as outcome measures in RTW promotion and provide a basis for designing targeted interventions for breast cancer survivors.

Pilot evaluation of the effectiveness of an ergonomics awareness educational programme addressed to middle-school children

BACKGROUND

Ergonomics programmes addressed to children fit the health-promoting schools (HPS) framework. Beyond the integration of ergonomics in curricula, an important aspect is the effectiveness of the programme. This pilot study aims to evaluate the effectiveness of the programme proposed to a sample of middle-school children (aged 10-13 years) of the metropolitan city of Cagliari.

METHODS

The programme was designed along the lines of the INAIL (Italian National Institute for Insurance against Accidents at Work) scheme and proposed to 260 children. It consisted of three phases: 1) assessment of students' background with a pre-intervention questionnaire (completed by 142 students); 2) teaching of the ergonomics training modules and evaluation of the weight of a sample of 160 backpacks, and of students' perception to be able to sit by putting their feet on the ground; 3) evaluation of conceptual understanding of ergonomics concepts with a post-intervention questionnaire (completed by 107 students out of the 142 students who completed phase 1).

RESULTS

There was a substantial improvement in the percentage of correct responses post-intervention, confirmed by the chi-square test, regarding concepts about ergonomics, backpack weight and handling. Most of the backpacks exceeded the maximum allowed value, and 20% of students were perceived to be unable to sit putting their feet on the ground.

CONCLUSIONS

The practical application of ergonomics pedagogy proved effective in the school setting and should be integrated into school curricula. The prevention technicians can offer a holistic approach, while the teachers are essential to implement the programme on a large scale. Effectiveness evaluation is necessary to guide resource allocation and implement and sustain the HPS approach. A tailored programme has a greater chance of reaching its target audience and maximizing effectiveness.

Funeral Industry Workers' Work Health and Safety in Australia and Ireland

Funeral workers (FWs) work within increasingly medicalized and commodified death-management systems. This study explored Worker Health and Safety (WHS) impacts in contemporary death management on Australian and Irish FWs. Mixed methods combined a survey and interviews. Survey data were descriptively summarized, interviews thematically analyzed, and a schematic systems model developed of the combined results. Survey participants (n = 45) reported psychosocial hazards from work pressures, competition, and fatigue. Psychosocial hazards were more frequently reported than physical hazards by Australian FWs. Physical hazards were of greater concern to Irish FWs. Themes from 11 interviews were: Personal Attributes, Work Demands, and Socio-Cultural Context. All FWs reported conflicts between individual capacities, work demands, and resources, resulting in hazardous personal states including difficulty sleeping and stress. Respectfully manually handling human remains and "event management" demands for increasingly elaborate funerals created negative WHS impacts. This research informs risk management for FWs and other workers in the increasingly complex death-care industry.

Workplace gender composition and sickness absence: A register-based study from Sweden

AIMS

This study aimed to examine the association between gender composition in the workplace and sickness absence days during a one-year period.

METHODS

The study population was drawn from the Northern Swedish Cohort (wave 3; 2007) by Statistics Sweden and consisted of all participants belonging to a specific workplace (n=837) as well as all co-workers at the workplace of the participants (n=132,464; 67,839 women and 64,625 men). Exposure was the gender composition of the workplace, and outcome was cumulative sickness absence days (⩾90 days or not) during 2007, provided through a link to the Database for Health Insurance and Labour Marked Studies of Statistics Sweden. Covariates were gender, age, educational level and branch of industry from the same data source. We performed descriptive analyses and multivariable regression analyses.

RESULTS

Workers in extremely female-dominated workplaces had a significantly higher risk of cumulative sickness absence days (⩾90 days) compared with gender-equal workplaces (fully adjusted odds ratio (OR)=1.27; 95% confidence interval (CI) 1.09-1.48), whereas those working in extremely and moderately male-dominated workplaces had a significantly lower sickness absence risk (OR=0.62 and 0.66, respectively). Stratified by gender, the higher absence risk at female-dominated workplaces was fully explained by variation in branches of industry. Women working in extremely male-dominated workplaces had a significantly lower absence risk (OR=0.75), as did men working in moderately male-dominated workplaces (OR=0.78).

CONCLUSIONS

Workplaces dominated by women had a significantly higher risk of days lost to sickness absence compared to gender-equal workplaces. Stratified by gender, this higher risk was explained by branch of industry.

A scoping review of factors associated with self-management in young adults with stroke

PURPOSE

To synthesize the available evidence on factors associated with self-management behavior in young stroke patients.

METHODS

The methodological guidelines for scoping reviews developed by the Joanna Briggs Institute and the PRISMA-scR-checklist for scoping reviews were used. A total of 5586 studies were identified through bibliographic searches of the scientific databases Medline (OVID), Embase (OVID), CINAHL (EBSCO), and PsycINFO, limited to the period 2000-2023. Studies were independently assessed for inclusion and exclusion criteria by two reviewers. Quantitative observational data and qualitative studies were extracted, mapped, and summarized to provide a descriptive summary of trends and considerations for future research.

RESULTS

Nine papers were finally selected to answer the research question. Young patients' self-management was mainly influenced by demographic factors (age, gender, income, education, and stroke knowledge), disease-related factors (functionality and independence, duration of stroke diagnosis, cognitive function, and poststroke fatigue), and psychosocial factors (hardiness, spiritual self-care, self-efficacy, and social support).

CONCLUSION

Further research is needed to determine the trajectory of poststroke self-management over time and its potential predictors, which should lead to the development of specific stroke rehabilitation and stroke self-management support programs for young people (considering factors that influence return to work in young stroke patients' self-management).

PRACTICE IMPLICATIONS

Healthcare providers can design more efficient interventions to improve the quality of life of young stroke patients after discharge. Gaining an in-depth understanding of the factors that influence self-management can help achieve this.

Violence in the healthcare workplace

PURPOSE OF REVIEW

Healthcare workers experience a disproportionate frequency of workplace violence. Identifying commonalities among incidents of workplace violence provides an opportunity for change to prevent and mitigate future violence.

RECENT FINDINGS

Despite a continued decline in overall workplace violence, the rate of violence in the healthcare sector is steadily rising. While healthcare workers make up 13% of the workforce, they experience 60% of all workplace assaults. Environmental, structural, and staffing issues may all contribute to the increased rates of workplace violence affecting healthcare workers.

SUMMARY

Comprehensive proactive workplace violence prevention programs can significantly reduce the frequency of violence and the negative impact on employees and institutions. Analyzing the factors that contribute to violence in the healthcare workplace provides the potential to mitigate these risks and reduce episodes of violence.

The effectiveness of the TRACE online nutrition intervention in improving dietary intake, sleep quality and physical activity levels for Australian adults with food addiction: a randomised controlled trial

BACKGROUND

Few interventions for food addiction (FA) report on dietary intake variables. The present study comprised a three-arm randomised controlled trial in adults with symptoms of FA. The aim was to evaluate dietary intake, sleep and physical activity resulting from a dietitian-led telehealth intervention at 3 months.

METHODS

Adults with ≥3 symptoms of FA and a body mass index > 18.5 kg/m2 were recruited. Dietary intake including energy, nutrients and diet quality were assessed by a validated food frequency questionnaire in addition to sleep quality and physical activity (total min) and compared between groups and over time. Personalised dietary goals set by participants were examined to determine whether improvements in percent energy from core and non-core foods were reported.

RESULTS

The active intervention group was superior compared to the passive intervention and control groups for improvements in percent energy from core (6.4%/day [95% confidence interval (CI) -0.0 to 12.9], p = 0.049), non-core foods (-6.4%/day [95% CI -12.9 to 0.0], p = 0.049), sweetened drinks (-1.7%/day [95% CI -2.9 to -0.4], p = 0.013), takeaway foods (-2.3%/day [95% CI -4.5 to -0.1], p = 0.045) and sodium (-478 mg/day [95% CI -765 to -191 mg], p = 0.001).

CONCLUSIONS

A dietitian-led telehealth intervention for Australian adults with FA found significant improvements in dietary intake variables. Setting personalised goals around nutrition and eating behaviours was beneficial for lifestyle change.

Mothers' Internet Journeys Through Social, Health Care, and Virtual Systems When Congenital Anomalies Are Diagnosed In Utero

OBJECTIVE

To examine mothers' internet usage, in conjunction with social, health care, and virtual peer support navigations, when congenital anomalies were diagnosed in utero.

DESIGN

Qualitative descriptive, consisting of semistructured interviews.

SETTING

Interview data were collected over Zoom; mothers participated from locations of their choosing.

PARTICIPANTS

Mothers of neonates discharged postoperatively from NICUs for uterine-diagnosed congenital anomalies. The sample was purposefully recruited from private Facebook groups for parents of children with congenital anomalies.

INTERVENTION/MEASUREMENTS

Analysis was done with deductive coding using concepts from the third iteration of the systems engineering initiative for patient safety theory. The a priori codes were health care, social, journey-benefit, journey-risk, task, and technology.

RESULTS

Twenty-two mothers signed up for an interview; 12 completed an interview, and 10 did not. The majority (n = 8, 66%) were White, had a bachelor's or graduate degree (n = 7, 58%) and were between 24 and 33 years of age (n = 8, 66%). Nine themes emerged: (a) Providers cautioned searching for diagnosis information but encouraged private Facebook groups for peer support, (b) Mothers' inquiries for their own care are lacking, (c) Search for information while recognizing parent-partner's coping differences, (d) Pace information from friends and family with patience and appreciation, (e) Manage inquiries from friends and family with group sharing, (f) Private Facebook groups provide a means of receiving and giving peer support, (g) Exposure to difficult stories on Facebook is a risk of stress, (h) Select a NICU, learn about their children's diagnoses, participate in virtual peer support, and (i) Device features frame search strategies.

CONCLUSION

Mothers reflected on the internet as a burden and a source of support in their health care journeys. The ubiquity of internet access calls for mothers to include in their health care journeys the complexities of managing time spent on the internet.

Effect of noise on the performance of arthroscopic simulator

Background

Noise is omnipresent in the operating room. The average noise in the operating room generally ranges between 60 and 65 dB and can sometimes exceed 100 dB, despite the ARS (Agence Régionale de Santé) and WHO (World Health Organization) recommending levels of 35 dB(A). This study aimed to evaluate the effect of different kinds of background auditory stimuli on the performance of surgeons during an arthroscopic simulation task.

Methods

Forty-seven surgeons with varying experience in arthroscopic surgery undertook different exercises under four different conditions: quiet, classical music, hard rock, and sustained chatter. All background auditory stimuli were set at 65 dB(A). Each participant underwent double randomization for the four sound stimuli and the four exercises to be performed. A musical questionnaire was also completed by each participant. Data related to each exercise included operating time in seconds, distance from the camera or instruments in centimeters, and an overall score automatically calculated by the simulator based on safety, economy of movement, and speed (scale: 0-20 points).

Results

Operative time in an environment with classical music was significantly lower than in an environment with hard rock (95.9 s vs. 128.7 s, p = 0.0003). The overall rating in an environment with chatter was significantly lower than in a silent environment (11.7 vs. 15.7, p < 0.0001). The overall rating in an environment with hard rock was significantly lower than in an environment with classical music (14.3 vs. 17.5, p = 0.0008).Surgeons who preferred listening to music in the operating room performed differently than those who did not. The mean operative time for surgeons who preferred music was 99.52 s (SD = 47.20), compared to 117.16 s (SD = 61.06) for those who did not prefer music, though this difference was not statistically significant (p = 0.082). The mean overall score for surgeons who preferred music was significantly higher at 17.46 (SD = 2.29) compared to 15.57 (SD = 3.49) for those who did not prefer music (p = 0.001).

Conclusions

Our study suggests that exposure to classical music and silence may confer greater benefits to the surgeon compared to the impact of hard rock and chatter. These conclusions are grounded in significant differences observed in operative time and overall evaluations, highlighting the potential advantages of an environment characterized by acoustic tranquility for surgical professionals. Preferences for music in the operating room also play a role, with those who prefer music demonstrating better performance scores.

Effectiveness of rehabilitation for young patients with extensive right hemisphere cerebral infarction: A report of two cases

Key Clinical Message

In younger patients, including those with extensive infarction involving the anterior and middle cerebral artery regions of the right hemisphere, appropriate treatment for rare causes and goal-oriented long-term rehabilitation could improve severe hemiplegia and higher brain dysfunction, and allow for further education and employment.

Abstract

Although the number of young stroke patients is small, many have serious sequelae and rare causes. In addition to independence in activities of daily living, education and employment are desired. We present two cases of extensive infarction in the right cerebrum in patients who underwent rehabilitation with good outcomes.

Permanent unfitness for work and mental disorders: a multicentric cross-sectional study of 2,788 unfit employees

In France, Mental Disorders (MD) are the second most common medical cause of unfitness-for-work notices. The main objective is to describe the MD causing permanent medically unfitness at the workstation. A cross-sectional multicenter survey was conducted among employees followed by 323 physicians from occupational health services of the South of France in 2017. The MD responsible for unfitness for the job were coded according to the ICD-10 nomenclature and their occupational origin was estimated by each physician. On 359,966 employees screened, 2,788 were unfitted. Among the 2,779 unfitness cases which were analysed, 985 were unfitted for MD. The incidence rate of unfitness for MD was 2.78 unfit per 1,000 employees followed. Representing 36.8% (985 cases) of all grounds for unfitness, MD were estimated to be work-related in 614 (63.6%) of cases. The main MD were 449 (45.6%) cases of major depressive episodes, 227 (23.0%) anxiety disorders and 131 (13.3%) recurrent depressive disorders. Their occupational origin was mentioned in 296 (67.3%), 168 (74.7%), 62 (49.6%) cases and the link with a Burnout (BO) in 166 (38.3%), 61 (27.9%) and 41 (34.2%) cases respectively among 364 all pathologies reported to a BO. Unfitness for MD was more common among women (ORa = 1.79 95% CI [1.50-2.13]), working in trade, transport, accommodation and catering (ORa = 1.47 95% CI [1.04-2.09]) and increase with age (ORa = 4.24 95% CI [2.73-6.60] for over 55). Major depressive episodes represent the MD most frequently responsible for unfitness and the most related to occupational origin.

Workplace-related determinants of mental health in food and bar workers in Western, high-income countries: A systematic review

BACKGROUND

This review synthesizes evidence from etiologic and intervention studies of workplace-related determinants of mental health in workers in food and bar workers in the hospitality industry in Western high-income countries.

METHODS

Peer-reviewed literature published between January 2000 and August 2023 was gathered from five bibliographic databases. Any study design was eligible. Study quality was assessed using the Joanna Briggs Institute tools for appraisal.

RESULTS

A narrative analysis was conducted for 26 included studies (total n = 15,069 participants) across Australia (3), Ireland (1), Norway (1), Spain (2), the United States (17) and the United Kingdom (2). Individual and task-related factors such as high emotional job demands and low job control were associated with high burnout and depression. Uncivil and hostile interpersonal interactions with customers, management, and colleagues were found to contribute to poor mental health outcomes, including depression, anxiety, and burnout.

CONCLUSION

Findings from included studies highlight the impact of workplace culture, including management practices and workplace social support, on mental health. Organization-level interventions may therefore be most effective for addressing individual, interpersonal, and organizational determinants of mental health in food and bar occupations, particularly when implemented as part of broader organizational efforts to support health and wellbeing. Industry-wide policy changes may also be necessary to address structural concerns, including job and financial insecurity, job strain and access to benefits, such as secure sick leave and minimum contract hours.

Musculoskeletal physiotherapists' experiences of using remote consultations during the COVID-19 pandemic: A qualitative study

BACKGROUND

The coronavirus (COVID-19) pandemic resulted in the rapid implementation of remote consultations to maintain musculoskeletal physiotherapy services. However, little is known about UK musculoskeletal physiotherapists' experiences of providing services during the COVID-19 pandemic.

OBJECTIVES

To explore musculoskeletal physiotherapists' experiences of using remote consultations in one area of England during the COVID-19 pandemic.

DESIGN

Qualitative study using hermeneutic phenomenology based on the approach of Gadamer.

METHODS

Semi-structured interviews with twelve musculoskeletal physiotherapists were conducted online using Microsoft Teams. Data were analysed using frameworks based on the philosophical concepts of Gadamer's hermeneutics.

FINDINGS

Musculoskeletal physiotherapists' experience of using remote consultations during the COVID-19 pandemic was framed by three concepts: therapeutic relationship, transformational change, and uncertainty. These concepts are underpinned by four main themes capturing their experiences: (1) Disconnection: Difficulties building a rapport and reduced non-verbal communication affected building an effective therapeutic relationship, (2) Necessity: Transformation of services to remote consultations was positive, although technology and connectivity issues had a negative impact, (3) Loss of control: Diagnostic uncertainty, being unprepared, and experience affected physiotherapists' clinical practice, (4) Protection: Peer support and the use of technology facilitated a feeling of protection for physiotherapists.

CONCLUSION

The findings of this study contribute to a better understanding of musculoskeletal physiotherapists' experience of using remote consultations during the COVID-19 pandemic. Implications for practice include the need to provide training for all musculoskeletal physiotherapists and undergraduates to enable the effective delivery of remote physiotherapy. Furthermore, digital infrastructure should be optimised to support future delivery of remote musculoskeletal physiotherapy services.

Cross-cultural adaptation, validation and psychometric properties of the Arabic version of the Nordic Musculoskeletal Questionnaire in office working population from Saudi Arabia

BACKGROUND

Office-workers who suffer from musculoskeletal pain/disability may experience reduced productivity and absenteeism from work. The Nordic Musculoskeletal Questionnaire (NMQ) is a valid, simple screening tool for the history and presence of self-perceived musculoskeletal symptoms in both general public and occupational settings.

OBJECTIVE

To translate and culturally adapt the NMQ into Arabic language and examine its psychometric properties.

METHODS

The published guidelines were followed to translate and adapt the NMQ into Arabic using a forward-backward process. Construct validity involved comparing NMQ responses with disability-related musculoskeletal questionnaires in different body regions, including the Neck Disability Index (NDI), Oswestry Disability Index (ODI), Quick-Disability of the Arm, Shoulder, and Hand (Quick-DASH), and Reduced Western Ontario and McMaster Universities Osteoarthritis Index (ArWOMAC). The reliability was evaluated using Cronbach's alpha for internal consistency and prevalence-adjusted bias-adjusted kappa (PABAK) for test-retest reliability.

RESULTS

The Arabic NMQ (Ar-NMQ) revealed excellent internal consistency (Cronbach's alpha = 0.85). For the test-retest reliability, the PABAK coefficient ranged between 0.50 and 1. The Ar-NMQ demonstrated strong construct validity. Participants reporting neck pain showed significantly elevated disability scores on the NDI (p < 0.05), while those with back pain exhibited higher ODI scores (p < 0.05). Moreover, individuals reporting shoulder, elbow, and wrist pain and disability displayed elevated Quick-DASH scores (p < 0.05). Similarly, participants reporting hip/thighs, knees, and ankle/feet pain/disability demonstrated significantly higher disability in ArWOMAC (p < 0.05).

CONCLUSION

The NMQ was successfully translated and adapted into Arabic language, providing a reliable and valid instrument for assessing pain in specific body regions in the Arabic-speaking population.

Physical work environment in an activity-based flex office: a longitudinal case study

OBJECTIVE

This study aimed to investigate and explore Occupational Health and Safety (OHS) management, office ergonomics, and musculoskeletal symptoms in a group of office workers relocating from cell offices to activity-based flex offices (AFOs).

METHODS

The analysis was based on qualitative interview data with 77 employees and longitudinal questionnaire data from 152 employees.

RESULTS

Results indicate that there was a need to clarify roles and processes related to the management of OHS. Self-rated sit comfort, working posture, and availability of daylight deteriorated and symptoms in neck and shoulders increased after the relocation and seemed to be influenced by many factors, such as difficulties adjusting the workstations, the availability of suitable workplaces, and age, sex, and individual needs.

CONCLUSION

Research on the long-term effects of physical work environments and management of (OHS) issues after implementing activity-based flex offices is sparse. This study demonstrates the importance of planning and organising OHS issue management when implementing an AFO, and to carefully implement office ergonomics among office workers.

Fluid Cognition Among Individuals With Systemic Lupus Erythematosus

OBJECTIVE

We sought to describe fluid cognition and its correlates among individuals with systemic lupus erythematosus (SLE).

METHODS

Participants (n = 199) were recruited from a population-based cohort for a single study visit (October 2019 to May 2022). Fluid cognition was measured via the National Institutes of Health Toolbox Fluid Cognition Battery (including episodic memory, working memory, attention and inhibitory control, processing speed, and cognitive flexibility domains) and expressed as age-corrected standard scores (mean 100, SD 15). Potential impairment was defined as a standard score >1.5 SD below the mean. Descriptive statistics were calculated and associations of various participant characteristics with the potential fluid cognition impairment were assessed with multivariable logistic regression.

RESULTS

Participants' mean age was 46.1 years; most were female (87.4%), Black (86.4%), and non-Hispanic (95.0%). The mean overall fluid cognition score was 87.2; of the individual domains, the participants' mean score was lowest on attention and inhibitory control (82.0). Working status (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.14-0.64) and higher self-reported physical functioning (OR 0.46, 95% CI 0.28-0.75) and physical performance (OR 0.72, 95% CI 0.59-0.87) were associated with lower odds of fluid cognition impairment; lower educational attainment was associated with higher odds (OR 3.82, 95% CI 1.67-8.75). Self-reported forgetfulness, neuropsychiatric damage, and depressive symptoms were not statistically significantly associated with potential impairment.

CONCLUSION

Fluid cognition and, particularly, attention and inhibitory control were low in those with SLE relative to the general US population. Working status, higher physical functioning and performance, and higher educational attainment were associated with lower prevalence of potential impairment. Future work is needed to develop and implement interventions to help support cognition in individuals with SLE.

Telework and 24-hour movement behaviours among adults living in Canada during the COVID-19 pandemic

OBJECTIVE

To assess the association between work location and movement behaviours (physical activity [PA], screen time, sleep) and adherence to the Canadian 24-Hour Movement Guidelines (24-H Guidelines) among Canadian workers during the COVID-19 pandemic.

METHODS

Using cross-sectional data from the 2021 Canadian Community Health Survey (n = 10,913 working adults 18-75 years), primary work location was categorized as: worked outside the home at a fixed location (fixed workplace), worked at home (telework), and worked outside the home at no fixed location (non-fixed workplace). Recreational, transportation and occupational/household PA, as well as leisure screen time and sleep duration were self-reported. Logistic regression assessed associations between work location and adherence to movement behaviour recommendations, adjusting for covariates.

RESULTS

Compared to a fixed workplace, those teleworking reported more recreational PA (21.1 vs 17.0 min/day, p < 0.0001) and sleep (7.2 vs 7.1 h/night, p = 0.026) and were more likely to meet sleep duration recommendations (adjusted odds ratio [aOR] = 1.28, 95% CI: 1.08-1.51) and the 24-H Guidelines (aOR = 1.25, 95% CI: 1.04-1.51). Compared to fixed workplaces, those at non-fixed workplaces reported more occupational PA (62.7 vs 32.8 min/day, p < 0.0001) and less leisure screen time (2.5 vs 2.7 h/day, p = 0.021), and were more likely to meet the PA recommendation (aOR = 1.46, 95% CI: 1.15-1.85) and the 24-H Guidelines (aOR = 1.38, 95% CI: 1.09-1.75).

CONCLUSIONS

Results suggest that adherence to the 24-H Guidelines varies by work location, and work location should be considered when developing strategies to promote healthy movement behaviours. Future studies could explore hybrid work arrangements, and longitudinal study designs.

Enhancing Aviation Safety through AI-Driven Mental Health Management for Pilots and Air Traffic Controllers

This article provides an overview of the mental health challenges faced by pilots and air traffic controllers (ATCs), whose stressful professional lives may negatively impact global flight safety and security. The adverse effects of mental health disorders on their flight performance pose a particular safety risk, especially in sudden unexpected startle situations. Therefore, the early detection, prediction and prevention of mental health deterioration in pilots and ATCs, particularly among those at high risk, are crucial to minimize potential air crash incidents caused by human factors. Recent research in artificial intelligence (AI) demonstrates the potential of machine and deep learning, edge and cloud computing, virtual reality and wearable multimodal physiological sensors for monitoring and predicting mental health disorders. Longitudinal monitoring and analysis of pilots' and ATCs physiological, cognitive and behavioral states could help predict individuals at risk of undisclosed or emerging mental health disorders. Utilizing AI tools and methodologies to identify and select these individuals for preventive mental health training and interventions could be a promising and effective approach to preventing potential air crash accidents attributed to human factors and related mental health problems. Based on these insights, the article advocates for the design of a multidisciplinary mental healthcare ecosystem in modern aviation using AI tools and technologies, to foster more efficient and effective mental health management, thereby enhancing flight safety and security standards. This proposed ecosystem requires the collaboration of multidisciplinary experts, including psychologists, neuroscientists, physiologists, psychiatrists, etc. to address these challenges in modern aviation.

Strategies for optimal management of pediatric acute agitation in emergency settings

Acute agitation in youth is a challenging presentation to the emergency department. In many cases, however, youth can be behaviorally de-escalated using a combination of environmental modification and verbal de-escalation. In cases where additional strategies such as pharmacologic de-escalation or physical restraint are needed, using the least restrictive means possible, including the youth in the decision-making process, and providing options are important. This paper reviews specific considerations on the approach to a youth with acute agitation and strategies and techniques to successfully de-escalate agitated youth who pose a danger to themselves and/or others.

Determinants and inequities in healthy working life expectancy in China

Many countries are raising the pension age to mitigate the challenges of population aging, but such a solution may ignore the disparities in health and working conditions across populations. Using large-scale longitudinal data from China, this study provides estimates of healthy working life expectancy (HWLE), defined as the average number of years expected to be spent healthy and in work from age 50 years, and highlights substantial inequities in HWLE by gender, socioeconomic status and geographical region. The HWLE from age 50 years was, on average, 6.87 (95% confidence interval: 6.70 to 7.04) years in China. Hypertension was the leading chronic condition for people working unhealthily (5.67 years for men and 4.85 years for women), and arthritis contributed the largest differences in unhealthy working years across people by occupation (agricultural laborer versus enterprise employee, 3.28 years). Moreover, adopting healthy lifestyles was associated with gains in HWLE (2.13 years for men and 1.61 years for women). Our findings suggest that increasing the pension age through a 'one-size-fits-all' approach may not effectively meet the goal of extending working lives. Inclusive initiatives aimed at targeted populations to promote health or work conditions and to facilitate the pension system will be essential to improve HWLE by reducing inequities.

Development of an ontology to characterize mental functioning

PURPOSE OF THE ARTICLE

This article describes a conceptual and methodological approach to integrating functional information into an ontology to categorize mental functioning, which to date is an under-developed area of classification, and supports our work with the United States (U.S.) Social Security Administration (SSA).

DESIGN AND METHODOLOGICAL PROCEDURES

Conceptualizing and defining mental functioning was paramount to develop natural language processing (NLP) tools to support our use case. The International Classification of Functioning, Disability, and Health (ICF) was the framework used to conceptualize mental functioning at the activities and participation level in clinical records. To address challenges that arose when applying the ICF as to what should or should not be classified as mental functioning, a mental functioning domain ontology was developed that rearranged, reclassified and incorporated all ICF key components, concepts, classifications, and their definitions.

CONCLUSIONS

Challenges emerged in the extent to which we could directly align components in the ICF into an applied ontology of mental functioning. These conceptual challenges required rearrangement of ICF components to adequately support our use case within the social security disability determination process. Findings also have implications to support future NLP efforts for behavioral health outcomes and policy research.

Return to work for stroke survivors with aphasia: A quantitative scoping review

The international incidence of stroke in people of working age is rising. As such, meaningful work return is a major rehabilitation goal for many individuals, including those with aphasia. This scoping review aimed to outline the post-stroke aphasia evidence related to work outcomes, factors influencing employment along with contemporary vocational-language and communication rehabilitation practice. The review employed terms related to aphasia, stroke, rehabilitation, and return to work in publications preceding 25.6.2023. Data were descriptively analysed, and vocational outcomes were summarized at defined timepoints. Of the 908 articles reviewed, 31 papers were included. Individuals with post-stroke aphasia consistently have lower rates of return to work than those post-stroke without aphasia. Employment at one year was 34.29% for those with aphasia compared to 58.46% for people without aphasia. No literature reported vocational-language assessment practices and there were minimal work-focused aphasia interventions identified. There was insufficient evidence to clearly identify person-related, rehabilitation, workplace or other factors influencing work return. This scoping review has identified that there are gaps in knowledge about the factors that influence work return and targeted vocational rehabilitation for this group. Future research to optimize return to work for individuals with aphasia is recommended.

Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Importance

Return to work after breast cancer (BC) treatment depends on several factors, including treatment-related adverse effects. While cancer-related cognitive impairment is frequently reported by patients with BC, to date, no longitudinal studies have assessed its association with return to work.

Objective

To examine whether cognition, assessed using objective and subjective scores, was associated with return to work 2 years after BC diagnosis.

Design, Setting, and Participants

In a case series of the French Cancer Toxicities (CANTO) cohort, a study of patients with stage I to III BC investigated cognition from April 2014 to December 2018 (2 years' follow-up). Participants included women aged 58 years or younger at BC diagnosis who were employed or looking for a job.

Main Outcomes and Measures

The outcome was return to work assessed 2 years after BC diagnosis. Objective cognitive functioning (tests), cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after treatment completion, and 2 years after diagnosis. Multivariable logistic regression models were used to explain return to work status at year 2 according to each cognitive measure separately, adjusted for age, occupational class, stage at diagnosis, and chemotherapy.

Results

The final sample included 178 women with BC (median age: 48.7 [range, 28-58] years), including 37 (20.8%) who did not return to work at year 2. Patients who returned to work had a higher (ie, professional) occupational class and were less likely to have had a mastectomy (24.1% vs 54.1%; P < .001). Return to work at year 2 was associated with lower overall cognitive impairment (1-point unit of increased odds ratio [1-pt OR], 0.32; 95% CI, 0.13-0.79; P = .01), higher working memory (1-pt OR, 2.06; 95% CI, 1.23-3.59; P = .008), higher processing speed (1-pt OR, 1.97; 95% CI, 1.20-3.36; P = .01) and higher attention performance (1-pt OR, 1.63; 95% CI, 1.04-2.64; P = .04), higher perceived cognitive abilities (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007), and lower depression (1-pt OR, 0.83; 95% CI, 0.74-0.93; P = .001) at year 2 assessment. Return to work at year 2 was associated with several measures assessed at baseline and year 1: higher processing speed (1-pt OR, 2.38; 95% CI, 1.37-4.31; P = .003 and 1.95; 95% CI, 1.14-3.50; P = .02), higher executive performance (1-pt OR, 2.61; 95% CI, 1.28-5.75; P = .01, and 2.88; 95% CI, 1.36-6.28; P = .006), and lower physical fatigue (10-pt OR, 0.81; 95% CI, 0.69-0.95; P = .009 and 0.84; 95% CI, 0.71-0.98; P = .02).

Conclusions and Relevance

In this case series study of patients with BC, return to work 2 years after diagnosis was associated with higher cognitive speed performance before and after BC treatment. Cognitive difficulties should be assessed before return to work to propose suitable management.

Improving Access to Yoga for Chronic Pain in a Spanish-Speaking Community: A Quality Improvement Initiative

BACKGROUND

The recent increase in opioid misuse and overdose among the Hispanic population signifies the need for an initiative to increase efforts in pain management in the Hispanic population. Yoga is an evidence-based therapeutic intervention that is effective for several pain-associated disorders. However, in the United States, it is primarily taught in English and not always accessible. This quality improvement (QI) project aimed to assess the outcome of implementing a yoga program on pain and quality of life in the Hispanic population.

METHODS

Twenty Spanish-speaking community center members participated in a linguistically-tailored yoga program over the course of 10 weeks that included educational, demonstration, and practice videos. Outcome measures of the QI program included changes in pain interference, physical function, opioid medication use, the overall impression of change in pain, satisfaction with the program, and the likelihood of continuation of yoga practice.

RESULTS

Data collected from participants (n = 16) after the 10-week period indicated that nearly 60% experienced an improvement in their overall impression of change in pain; their reported likelihood of continuation of yoga practice at home or another location were 6.8 and 7.4, respectively, on a 10-point scale. While pain interference was unaffected, there was an improvement in markers of physical function, including a two-fold improvement in general activity without limitations. The mean average intensity of pain decreased by 33%.

CONCLUSION

The use of a linguistically-tailored yoga program improved self-reported overall pain, physical function, average intensity of pain, and initiated an interest in participants in utilizing yoga practice for self-management of pain. This QI project provides results that can be used for further implementation initiatives at other sites and consideration of use in diverse populations.

Frequencies and predictors of subcutaneous and intraosseous injection with 4 epinephrine autoinjector devices

BACKGROUND

To prevent anaphylaxis-associated illness, intramuscular epinephrine injection is recommended. Subcutaneous injection may reduce efficacy, and intraosseous injection promotes morbidity. A few studies suggested that commercially available thigh epinephrine autoinjectors (EAIs) may induce subcutaneous/intraosseous injection in some adults.

OBJECTIVE

To estimate the subcutaneous/intraosseous-injection rates of 4 EAIs by comparing their needle lengths with the ultrasound-measured skin-to-muscle depth and skin-to-bone depth of the midthigh of adults with allergic diseases in a cross-sectional study and to determine patient factors that predict subcutaneous EAI injection.

METHODS

Thigh ultrasound was conducted in a convenience-recruited cohort with minimal and maximal compression to estimate the effect of EAI-induced compression. Subcutaneous/intraosseous-injection rates were estimated for Anapen (BioProject), EpiPen (Mylan), Jext (ALK), and Emerade (Medeca). Multivariate analyses for subcutaneous-injection risk were conducted with age, male/female sex, abdominal and thigh circumferences, and upper-arm skinfold thickness.

RESULTS

A total of 68 patients were recruited. Compression thinned the subcutaneous tissue and muscle by 1 and 9 mm, respectively, on average. Projected subcutaneous-injection rates with/without compression were high for Anapen (65%-66%), moderate for EpiPen and Jext (29%-38%), and lowest for Emerade (13%-21%). Compression introduced a small intraosseous-injection risk with Emerade (4%). Female sex predicted subcutaneous injection (odds ratio, 1.3-2.0; all P < .001). Depending on the EAI, 29% to 97% of women and 0% to 41% of men would be injected subcutaneously. Older men were at risk of intraosseous Emerade injection. Obesity-related variables predicted subcutaneous injection poorly.

CONCLUSION

Anapen was associated with high subcutaneous-injection rates. EpiPen and Jext were projected to provide intramuscular injection in all men without risk of intraosseous injection. Emerade yielded the lowest subcutaneous-injection rates in women. Compression largely affected the muscle.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02886468.

Guided self-help mindfulness-based intervention for increasing psychological resilience and reducing job burnout in psychiatric nurses: A randomized controlled trial

AIMS

The present study aimed to explore the effects of a guided self-help mindfulness intervention on psychological resilience and job burnout among psychiatric nurses.

BACKGROUND

Psychiatric nurses work in challenging and potentially high stress settings. Mindfulness interventions can improve psychological resilience and reduce job burnout of nurses. However, face-to-face delivery of mindfulness interventions may be inconvenient for individuals. Guided self-help interventions may be more accessible.

METHODS

This randomized controlled trial was conducted from January to August 2022. One hundred and eighteen psychiatric nurses were randomized into the intervention and control groups. The individuals in the intervention group received an 8-week guided self-help mindfulness intervention, while the individuals in the control group received a psycho-educational brochure. The Five Facet Mindfulness Questionnaire, the Connor-Davidson Resilience Scale and the Maslach Burnout Inventory-Human Services Survey were used to evaluate the levels of mindfulness, psychological resilience and job burnout, respectively.

RESULTS

After an 8-week intervention, compared with the control group, the levels of mindfulness and psychological resilience were higher, while the level of job burnout was lower in the intervention group.

CONCLUSIONS

The guided self-help mindfulness intervention can improve psychological resilience and reduce job burnout among psychiatric nurses.

Physiological and metabolic responses of Parabadminton athletes to field simulated effort

BACKGROUND

Due to the increase in the number of Parabadminton (PBd) athletes and the lack of scientific knowledge of the sport, it is important to evaluate performance variables in different game stimuli. Thus, this study sought to examine the physiological and metabolic responses in a simulated effort protocol in PBd athletes.

METHODS

Forty-seven volunteers (WH1=7; WH2=9; SL3=8; SL4=9; SU5=6; SH6=8) performed a simulated effort protocol, consisting of 2 blocks of activities (1st change of direction + 1st simulated effort; 2nd change of direction + 2nd simulated effort). Peak and average oxygen consumption (VO2peak and VO2avg), peak, percentage, and average heart rate (HRmax, %HRmax, and HRavg), percentage of carbohydrates and lipids contributions (%CARB and %FAT), and average and total energy expenditure (EEavg and EEtotal) were evaluated. The data was compared between protocol stages, functional classes (FCs), and court size. It was adopted P<0.05.

RESULTS

Differences were found between the stages of the protocol in VO2peak (P=0.0008), VO2avg (P=0.0004); HRmax (P<0.0001); %HRmax (P=0.0001), HRavg (P=0.0001), %CARB (P=0.0001), %FAT (P=0.0001), EEavg (P=0.0002), and EEtotal (P=0.008). Among FCs, SL4 athletes were superior to WH1 athletes for VO2peak (P=0.075), VO2avg (P=0.022), EEavg (P=0.011), and EEtotal (P=0.022). Athletes who completed protocol in the full court were greater than half court for VO2peak (P<0.001), VO2avg (P<0.001), %HRmax (P=0.032), HRavg (P=0.018), %CARB (P=0.022), %FAT (P=0.022), and EEavg (P=0.016).

CONCLUSIONS

PBd athletes belonging to higher FCs (4, 5, and 6) and who cover greater distances on the court exhibit physiological and metabolic responses under greater influence of the type of disability.

Relationships Between Physical Ability Test Performance and Fitness in Recruits From a Southeastern U.S. Police Department

ABSTRACT

Lockie, RG, Orr, RM, Sanchez, KJ, Gonzales, SM, Viramontes, E, Kennedy, K, and Dawes, JJ. Relationships between physical ability test performance and fitness in recruits from a southeastern U.S. police department. J Strength Cond Res 38(8): 1472-1478, 2024-Police recruit occupational ability may be predicted by a physical ability test (PAT). This study determined relationships between a department-specific PAT and fitness test performance among police recruits. Retrospective analysis was conducted on recruit data (1,069 men and 404 women) from one department collected during 2005-2009 and 2016-2020. The following data were provided: grip strength; sit-and-reach; 60-second push-ups; 60-second sit-ups; 2.4-km run; and the PAT. The PAT involved exiting a vehicle and opening the trunk; running ∼201 m; completing an obstacle course; dragging a 68-kg dummy 31 m; completing an obstacle course and running ∼201 m; dry firing a weapon 6 times with each hand; and trunk item placement and vehicle reentry. Relationships between the PAT and fitness tests were measured by partial correlations and stepwise linear regression, both controlling for sex. The PAT was completed in a mean time of 4:16 ± 1:07 minutes:seconds. The PAT significantly ( p < 0.001) related to all fitness tests. Moderate relationships were found for push-ups ( r = -0.35), sit-ups ( r = -0.41), and the 2.4-km run ( r = -0.43). Small relationships were found with grip strength ( r = -0.19) and the sit-and-reach ( r = -0.17). The final regression model, which included sex and all fitness tests except the sit-and-reach, explained ∼53% of the variance. Sex and the 2.4-km run explained ∼47% of the variance. Aerobic fitness appeared to have the greatest impact on PAT performance, which may have related to the PAT design and duration. Tasks completed in succession, and the use of a relatively light dummy, may stress aerobic fitness and muscular endurance to a greater extent.