Pre-pregnancy mental distress and musculoskeletal pain and sickness absence during pregnancy - a twin cohort study

Voice Quality of Life and Musculoskeletal Symptoms of Pregnant Women

INTRODUCTION

Quality of life in terms of voice and musculoskeletal symptoms can be affected, especially at the end of pregnancy when major physical changes occur.

OBJECTIVE

To analyze the results of vocal self-assessment and musculoskeletal symptoms of pregnant women in the second and third trimester.

METHODS

Forty-nine pregnant women in the second and third trimester aged between 18 and 40years were examined using the Nordic Musculoskeletal Questionnaire and the Voice-Related Quality of Life Questionnaire. The data were statistically analyzed using the R environment (R Core Team, 2019) with parametric (Student's t, chi-square, and Wald) and nonparametric (Mann-Whitney and Wilcoxon) tests, taking into account a nominal significance level of 5%.

RESULTS

Voice-related quality of life: mean total score and socio-emotional domain significantly within the normal values; physical domain significantly below the normal value; larger number of pregnant women significantly below the normal value in the physical domain. Nordic Musculoskeletal Questionnaire: most of the examined aspects showed a significant negative response; there was a positive significance for the presence of pain and tingling in the lower back; pregnant women with musculoskeletal complaints and impairments showed a significant decrease in the three domains of voice-related quality of life, mainly in the physical domain.

CONCLUSION

Pregnant women showed a deterioration in the physical domain of voice-related quality of life and the presence of pain and tingling in the lower back. Pregnant women who had discomfort and musculoskeletal impairments also showed a deterioration in voice-related quality of life, mainly in the physical domain.

Gender differences in the associations between childhood adversity and psychopathology in the general population

PURPOSE

To explore gender differences of the associations between childhood adversity (CA) subtypes and psychiatric symptoms in the general population.

METHODS

Data of 791 participants were retrieved from a general population twin cohort. The Symptom Checklist-90 Revised (SCL-90) and the Childhood Trauma Questionnaire were used to assess overall psychopathology with nine symptom domains scores and total CA with exposure to five CA subtypes, respectively. The associations between CA and psychopathology were analyzed in men and women separately and were subsequently compared.

RESULTS

Total CA was associated with total SCL-90 and all symptom domains without significant gender differences. However, the analyses of CA subtypes showed that the association between emotional abuse and total SCL-90 was stronger in women compared to men [χ2(1) = 4.10, P = 0.043]. Sexual abuse was significantly associated with total SCL-90 in women, but emotional neglect and physical neglect were associated with total SCL-90 in men. Exploratory analyses of CA subtypes and SCL-90 subdomains confirmed the pattern of gender-specific associations. In women, emotional abuse was associated with all symptom domains, and sexual abuse was associated with all except phobic anxiety and interpersonal sensitivity. In men, emotional neglect was associated with depression, and physical neglect was associated with phobic anxiety, anxiety, interpersonal sensitivity, obsessive-compulsive, paranoid ideation, and hostility subdomains.

CONCLUSION

CA is a trans-syndromal risk factor regardless of gender. However, differential associations between CA subtypes and symptom manifestation might exist. Abuse might be particularly associated with psychopathology in women, whereas neglect might be associated with psychopathology in men.

Predictors of the return to work for pregnant employees on preventive leave: Patients from an occupational medicine consultation in Switzerland

According to the Swiss legislation on maternity protection in the workplace (OProMa), if pregnant workers are exposed to occupational hazards and no protective measures are taken, a gynecologist will prescribe a certificate of preventive leave and the women must stop working. Returning to work is only possible if job adjustments are made. This study aims to evaluate the burden of absences on companies and to examine the predictors of the return to work for pregnant workers on preventive leave, by examining both the probability of return to work and the time required to return to work. The study sample includes data on 258 workplaces of pregnant workers on preventive leave, collected during an occupational medicine consultation aimed at supporting the implementation of the OProMa. Information is available on the worker (age, date of consultation), the hazards to which she is exposed, the company's knowledge of the OProMa and whether a risk analysis exists. Descriptive statistics and multivariate regression analysis are carried out. In 58% of the workplaces, it was not possible to return to work before the end of the pregnancy. This corresponds to an average absence of 4.5 months. In 42% of the workplaces, a return to work was possible thanks to workplace adaptations. A conforming risk analysis and a full knowledge of the OProMa for companies, and an early visit to the occupational medicine consultation for workers are good predictors of the likelihood of returning to work. Younger age and exposure to certain types of risks are factors that influence the duration of preventive leave. The implementation of OProMa in Switzerland poses serious challenges, but early identification of occupational hazards and practices that anticipate compliance with the law in the company increase the return to work in safety for pregnant workers.

Beneficial and harmful effects of physical activity on care-seeking for low back pain: the AUTBACK study

PURPOSE

People who seek more care for low back pain (LBP) tend to experience poorer recovery (e.g. higher pain and disability levels). Understanding the factors associated with care-seeking for LBP might improve patient outcomes and potentially alleviate the burden of LBP on global health systems. This study aimed to investigate the relationship between different intensities, volumes, and domains of physical activity and care-seeking behaviours, in people with a history of LBP.

METHODS

Longitudinal data from adult twins were drawn from the AUstralian Twin BACK study. The primary outcome was the total self-reported frequency (counts) of overall utilisation of care for LBP, over 1 year. Secondary outcomes were the utilisation of health services, and the utilisation of self-management strategies, for LBP (assessed as total frequency over 1 year). Explanatory variables were device-based measures of sedentary behaviour and moderate-to-vigorous intensity physical activity, and self-reported physical workload, and work, transport, household, and leisure domain physical activity, at baseline.

RESULTS

Data from 340 individuals were included. Median age was 56.4 years (IQR 44.9-62.3 years) and 73% of participants were female. Medium-to-high baseline volumes of sedentary behaviour were significantly associated with greater counts of overall care utilisation (IRR 1.60, 95%CI 1.04-2.44) and utilisation of self-management strategies (IRR 1.60, 95%CI 1.02-2.50) for LBP, over 1 year. Medium-to-high baseline volumes of household domain physical activity were significantly associated with greater counts of utilising self-management strategies for LBP over 1 year (IRR 1.62, 95%CI 1.04-2.53). No explanatory variables were associated with the utilisation of health services for LBP.

CONCLUSION

People who engage in higher baseline volumes of sedentary behaviour or physical activity in the household setting (e.g. housework, gardening, yard work, general household maintenance) utilise 1.6 times more care for LBP over 1 year. Findings suggest that higher volumes of these behaviours may be harmful for LBP. No intensities, volumes, or domains of physical activity demonstrated clear benefits for LBP. Where feasible, patients and clinicians should collaborate to screen and develop strategies to reduce engagement in sedentary behaviour or physical activity in the household setting. Contextual factors (e.g. patient symptom severity, sociocultural roles, occupational demands) should be considered when devising appropriate behaviour change strategies.

Women's Health and Working Life: A Scoping Review

Women's health matters for participation in working life. The objective of this study was to explore female physiology in a work-life context and to investigate possible associations between women's health, sickness absence and work ability. A scoping review was conducted to develop a systematic overview of the current research and to identify knowledge gaps. The search strategy was developed through a population, concept and context (PCC) model, and three areas of women's health were identified for investigation in the context of work. A total of 5798 articles were screened by title and abstract and 274 articles were screened by full text; 130 articles were included in the review. The material included research from 19 countries; the majority of the studies used quantitative methods. The results showed an impact on the occupational setting and an association between sickness absence, work ability and all three areas of women's health, but a holistic and overall perspective on female biology in the work context is missing. This review calls for more knowledge on health and work and possible gender differences in this regard. Women's health and working life involve a complex connection that has the potential to develop new knowledge.

A Life Course Study of Genetic and Environmental Influences on Work Incapacity

Work incapacity is a major public health challenge and an economic burden to both society and individuals. Understanding the underlying causes is becoming ever more relevant as many countries face an aging workforce. We examined stability and change in genetic and environmental factors influencing work incapacity from age 18 until retirement, and sex differences in these effects. The large population-based sample comprised information from 28,759 twins followed for up to 23 years combined with high-quality national registry data. We measured work incapacity as the total proportion of potential workdays lost due to sickness absence, rehabilitation and disability benefits. Structural equation modeling with twin data indicated moderate genetic influences on work incapacity throughout life in both men and women, with a high degree of genetic stability from young to old adulthood. Environmental influences were mainly age-specific. Our results indicate that largely the same genetic factors influence individual differences in work incapacity throughout young, middle and older adulthood, despite major differences in degree of work incapacity and probable underlying medical causes.

Being in a bubble - Childbirth as a potential path towards becoming in health - Lived experiences of mothers during childbirth

BACKGROUND

Childbirth is often seen as an existentially important life event. However, few studies focus on the experience from the woman's perspective.

THE AIM AND RESEARCH QUESTIONS

The aim of this study was to explore women's experiences of strength and health during childbirth through an ontological understanding. What enables women to experience strength and health during childbirth?

RESEARCH DESIGN, PARTICIPANTS AND RESEARCH CONTEXT

A hermeneutical approach was used. The material consists of texts from interviews with eight women who have recently (a few days to some weeks) given birth. The texts were interpreted through latent content analysis.

ETHICAL CONSIDERATIONS

Informed consent was sought from the participants regarding participation in the study and the storage and handling of data for research purposes.

FINDINGS

The overall theme was 'Childbirth as a movement towards becoming in health'. The three main themes were as follows: 'The self as a source of strength', 'The other as a source of strength in communion' and 'Alleviation of suffering as a source of strength'. Seven subthemes were also described.

CONCLUSION

Childbirth may be seen as a potential path towards becoming in health. The midwife has a central position in supporting women's experiences of health. Family-centred care may enhance women's experiences of becoming in health during childbirth. Further research in this field should focus on revealing midwives' perspectives on what gives women health in connection with childbirth.