Structural equation modelling of lower back pain due to whole-body vibration exposure in the construction industry

ACL Injury Etiology in Its Context: A Systems Thinking, Group Model Building Approach

Background/Objectives: Given the complex nature of Anterior Cruciate Ligament (ACL) injury, it is important to analyze its etiology with suitable approaches in order to formulate intervention strategies for effective prevention. The present study employs system thinking techniques to develop a Causal Loop Diagram (CLD) Model for investigating the risk factors for ACL Injury (CLD-ACLI), through a Group Model Building approach. Methods: A two-stage procedure was applied involving a comprehensive literature review followed by several systems thinking group-modeling co-creation workshops with stakeholders. Results: Based on input from experts and stakeholders, combined with the latest scientific findings, the derived CLD-ACLI model revealed a series of interesting complex nonlinear interrelationships causal loops between the likelihood of ACL injury and the number of risk factors. Particularly, the interaction among institutional, psychological, neurocognitive, neuromuscular, malalignment factors, and trauma history seem to affect neuromuscular control, which subsequently may alter the biomechanics of landing, predisposing the ACL to injury. Further, according to the proposed CLD-ACLI model, the risk for injury may increase further if specific environmental and anatomical factors affect the shear forces imposed on the ACL. Conclusions: The proposed CLD-ACLI model constitutes a rigorous useful conceptual presentation agreed upon among experts on the dynamic interactions among potential intrinsic and extrinsic risk factors for ACL injury. The presented causal loop model constitutes a vital step for developing a validated quantitative system dynamics simulation model for evaluating ACL injury-prevention strategies prior to implementation.

Effect of Vibration on Acute and Chronic Back Pain After Spinal Anesthesia: A Randomized Clinical Trial

Background

Post-spinal anesthesia back pain often initiates with needle insertion and may persist for months, particularly among young women following cesarean section. Mechanical vibration has been proposed as an effective method to alleviate this pain.

Objectives

The study aimed to evaluate the impact of vibration on reducing pain experienced during needle insertion, as well as its effects one week and one-month post-puncture.

Methods

This randomized clinical trial enrolled patients undergoing spinal anesthesia for various surgical procedures. Patients were randomly assigned to either receive routine spinal anesthesia or spinal anesthesia combined with vibration. Demographic data were collected, and pain levels during needle insertion and back pain were assessed using a visual analog scale (VAS).

Results

A total of 64 patients were included in the study. There were no significant differences between the two groups in terms of the number of attempts required for needle insertion (P = 0.341), the predominant anatomical level, or the needle approach (midline or paramedian). Ultimately, pain experienced during needle insertion, back pain after one week, and back pain after one month did not differ significantly between the two groups (P = 0.562, P = 0.14, and P = 0.267, respectively).

Conclusions

The results of the present study showed that vibration at the site of needle insertion during spinal anesthesia had no effect on acute and chronic back pain on subsequent follow-up due to spinal anesthesia.

Factors influencing job satisfaction among dentists during the new normal of the COVID-19 pandemic in Indonesia: A structural equation modeling approach

BACKGROUND

Dentistry is one of the highest risk occupations that face COVID-19, especially in countries that are severely affected by the pandemic, such as Indonesia.

OBJECTIVE

The purpose of the study was to determine factors influencing job satisfaction among dentists during the new normal of COVID-19 pandemic in Indonesia by utilizing the Structural Equation Modeling (SEM) approach.

METHODS

A total of 310 Indonesian dentists voluntary completed an online questionnaire, which contained 58 questions. Several latent variables such as perceived severity of COVID-19, staff cooperation and management commitment, personal protective equipment, job stress, working hours, income, and overall job satisfaction were analyzed simultaneously.

RESULTS

SEM revealed perceived severity of COVID-19 had significant effects on job stress (β:0.394, p = 0.025) and the utilization of personal protective equipment (β:0.757, p = 0.001). Subsequently, job stress (β:-0.286, p = 0.001), working hours (β:0.278, p = 0.018), income (β:0.273, p = 0.003), personal protective equipment (β:0.145, p = 0.038), and staff cooperation & management commitment (β:0.091, p = 0.002) were found to have significant effects on overall job satisfaction. In addition, management & staff cooperation was found to have a significant association with job stress reduction (β:-0.319, p = 0.003) which subsequently led to higher satisfaction.

CONCLUSIONS

The current study is one of the first that analyzed job satisfaction among dentists in Indonesia during the global COVID-19 pandemic. The integrated latent variables can be applied and extended to evaluate job satisfaction among dentists during the COVID-19 pandemic in other countries. Finally, this study contributed as a theoretical foundation for policymakers to enhance the job satisfaction of dentists during the COVID-19 pandemic.

Risk Perception and Coping Behavior of Construction Workers on Occupational Health Risks-A Case Study of Nanjing, China

To reduce harm caused by occupational health risks of construction workers exposed to working environments, especially those for interior decoration, it is crucial for them to actively recognize and prevent these risks. Therefore, how to improve their occupational health risks perception and regulate their coping behaviors should be of great concern. However, most prior studies target construction worker safety, and little research focuses on risk analysis from the psychological level of workers. Hence, construction workers' occupational health risk perception level and coping behavior level in Nanjing and the influencing factors were analyzed through statistical analysis with 341 valid questionnaires. Bootstrapping was applied to test the mediating effects of risk perception on the proposed factors and coping behaviors. This study revealed that construction workers have a high-level of occupational health risk perception, yet low-level coping behavior. Gender, age, education level, and unit qualification cause differences in individual risk perception level. Personal knowledge and group effects significantly affect the level of risk perception, which subsequently affect coping behavior. Education level, monthly income, and personal knowledge influence the coping behavior through risk perception. Recommendations were put forward for risk perception and coping behavior improvement from the perspectives of construction workers themselves, enterprises, and governments. This study sheds new light for research areas of occupational health and risk management and provides beneficial practice for improving construction workers' responses to occupational health risks.