The Brazilian Portuguese version of the revised Maastricht Upper Extremity Questionnaire (MUEQ-Br revised): translation, cross-cultural adaptation, reliability, and structural validation

Cannabinol (CBN; 30 and 300 mg) effects on sleep and next-day function in insomnia disorder ('CUPID' study): protocol for a randomised, double-blind, placebo-controlled, cross-over, three-arm, proof-of-concept trial

OBJECTIVE

Insomnia is the most prevalent sleep disorder, with few effective pharmacotherapies. Anecdotal reports and recent preclinical research suggest that cannabinol (CBN), a constituent of Cannabis sativa derived from delta-9-tetrahydrocannabinol, could be an effective treatment. Despite this, the isolated effects of CBN on sleep have yet to be systematically studied in humans.

METHODS

The present protocol paper describes a randomised, double-blind, placebo-controlled, single-dose, three-arm, cross-over, proof-of-concept study which investigates the effects of CBN on sleep and next-day function in 20 participants with clinician-diagnosed insomnia disorder and an Insomnia Severity Index Score ≥15. Participants receive a single fixed oral liquid dose of 30 mg CBN, 300 mg CBN and matched placebo, in random order on three treatment nights; each separated by a 2-week wash-out period. Participants undergo overnight sleep assessment using in-laboratory polysomnography and next-day neurobehavioural function tests. The primary outcome is wake after sleep onset minutes. Secondary outcomes include changes to traditional sleep staging, sleep-onset latency and absolute spectral power during non-rapid eye movement (NREM) sleep. Tertiary outcomes include changes to sleep spindles during NREM sleep, arousal indices, absolute spectral power during REM sleep and subjective sleep quality. Safety-related and exploratory outcomes include changes to next-day simulated driving performance, subjective mood and drug effects, postural sway, alertness and reaction time, overnight memory consolidation, pre and post-sleep subjective and objective sleepiness; and plasma, urinary, and salivary cannabinoid concentrations. The study will provide novel preliminary data on CBN efficacy and safety in insomnia disorder, which will inform larger clinical trials.

ETHICS AND DISSEMINATION

Human Research Ethics Committee approval has been granted by Bellberry (2021-08-907). Study findings will be disseminated in a peer-reviewed journal and at academic conferences.

TRIAL REGISTRATION NUMBER

NCT05344170.

Telework Conditions, Ergonomic and Psychosocial Risks, and Musculoskeletal Problems in the COVID-19 Pandemic

OBJECTIVE

To evaluate the association of telework conditions with ergonomic and psychosocial risks and with the occurrence of musculoskeletal problems among employees of the Brazilian Labor Judiciary during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted with 934 workers from August to October 2021. The data were collected via Web using a self-administrated questionnaire survey. Nonparametric tests and generalized linear regression analysis were used.

RESULTS

Previous experience in telework was associated with a better evaluation of the home workstation, a lower increase in workload, a greater increase in productivity, and greater preference to continue teleworking after the pandemic. The lack of a place dedicated to telework was specially related to greater ergonomic and psychosocial risks and to the greater occurrence of musculoskeletal problems.

CONCLUSIONS

Companies should monitor telework conditions to reduce health risks among their employees.

Ergonomic and psychosocial risks related to musculoskeletal problems among Brazilian labor judges in telework during the COVID-19 pandemic

AbstractObjectives. The aim of this study was to evaluate the ergonomic and psychosocial risks in telework and their relationship with musculoskeletal problems in Brazilian labor judges during the COVID-19 pandemic. Methods. A cross-sectional study was conducted with 119 participants. The data were collected through a sociodemographic and occupational questionnaire, from the Brazilian versions of the Maastricht Upper Extremity Questionnaire (MUEQ-Br revised), the Rapid Office Strain Assessment (ROSA-Br) and the Nordic Musculoskeletal Questionnaire (NMQ), added to a numerical pain scale. Results. According to ROSA-Br, 47.06% of the participants showed an outcome where it is considered that there is a need for immediate intervention in the workplace. The results of ROSA-Br and MUEQ-Br revised presented a significant correlation with the intensity of complaints in the neck and shoulders in the last 12 months and in the last seven days. The total score of MUEQ-Br revised presented more important correlations with problems in these body regions and with the intensity of complaints in the upper back, wrists/hands and lower back in both periods. Conclusions. Companies should propose ways to assess the ergonomic and psychosocial risks among their employees in telework as a way to prevent the occurrence of musculoskeletal problems.

Telework during the COVID-19 pandemic: Ergonomic and psychosocial risks among Brazilian labor justice workers

BACKGROUND

The imposition of telework by the COVID-19 pandemic represented a challenge for companies and workers with regard to the management and organization of the workplace at home.

OBJECTIVES

To evaluate the ergonomic risks, psychosocial factors and musculoskeletal symptoms as well as the relationships between these variables in employees of a Brazilian labor judiciary unit.

METHODS

A cross-sectional study was carried out with 55 employees who had their workstations evaluated by means of the Rapid Office Strain Assessment (ROSA-Br) and answered a questionnaire of sociodemographic and occupational characterization, the dimensions of workstation and posture of the Maastricht Upper Extremity Questionnaire (MUEQ-Br-revised), the short version of the Job Stress Scale and the Nordic Musculoskeletal Questionnaire (NMQ).

RESULTS

The workstations evaluations by ROSA-Br and MUEQ-Br-revised showed a strong correlation between themselves and to body posture, but they were not related to the occurrence of musculoskeletal symptoms. Body posture and demands were correlated to each other and with to occurrence of musculoskeletal symptoms. Shoulders, neck and wrists / hands were the most affected body regions.

CONCLUSIONS

Companies that adopt teleworking for their employees must be aware of working conditions at home, including the workload, and offer adequate support in order to prevent the occurrence of musculoskeletal problems.

Ergonomic evaluation of computer workers

Introduction

Information technologies have become indispensable in the office environment with a considerable increase in the use of computers. Musculoskeletal complaints in computer workers have a multifactorial etiology; therefore, an ergonomic investigation should be based on both self-reporting of symptoms and quantifiable observational methods.

Objectives

This study aimed to evaluate ergonomic and biomechanical characteristics of computer workers to identify the presence of symptoms and to assess the existence of a correlation between experts' observational assessment and workers' self-perception.

Methods

Participants were approached by an observer responsible for screening of symptoms and demographic characteristics. Volunteers were then evaluated simultaneously by two blinded observers.

Results

Seventy-one computer workers participated, and no significant differences were observed for duration of work on a computer between participants with and without pain. Interobserver reliability was good (0.93, 95%CI 0.88-0.96). No correlation was found between Maastricht Upper Extremity Questionnaire and Rapid Office Strain Assessment scores (p = 0.054/r = 0.230). There was no difference between participants with and without pain in the Rapid Office Strain Assessment (p = 0.931). In the Maastricht Upper Extremity Questionnaire assessment, there were differences in job demand (p = 0.004), complaints (p = 0.034), and total score (p = 0.044), with higher scores for asymptomatic participants.

Conclusions

The results suggest that asymptomatic individuals are subject to higher job demands probably because they have not previously experienced significant pain. However, they have other complaints, such as stiffness, disability, weakness, edema, and paresthesia. Symptomatic individuals, in turn, have greater trouble in aspects such as reduced amount of time spent on work and performance of work requiring extra effort.

Evaluation of psychometric properties of the maastricht upper extremity questionnaire (MUEQ) in iranian computer users

BACKGROUND

Measurement of the essential risk factors for work-related musculoskeletal disorders is a fundamental step in predicting the problem and identifying high-risk individuals. In this regard, Maastricht upper extremity questionnaire (MUEQ) has not been validated in Iran. This study aimed to develop a valid and reliable Persian version of MUEQ.

MATERIALS AND METHODS

In this descriptive study, the computer users employed in a governmental informatics administration in Tehran, Iran, were included during the end of 2018 and early 2019. Face and content validity of the MUEQ was conducted, and a six-part questionnaire was provided. The reliability of the questionnaire was obtained using Cronbach's α and test-retest. Concurrent validity was assessed with Nordic Musculoskeletal Questionnaire (NMQ). Exploratory and confirmatory factor analysis, comparison test of independent mean, internal consistency coefficient, test-retest, and Pearson correlation were carried out using the AMOS and SPSS 22 software.

RESULTS

Participants consisted of 282 computer users (110 males) with a mean age of 35.17 ± 7.65 years. The mean duration of computer use in a working day was 6.68 ± 2.10 h with a range of 1-12 h. The most prevalent symptoms were existed in the neck (39.1%), back (31.0%), and lower back (30.3%) areas. KMO test and Bartlett's test of sphericity showed that a significant correlation existed among questions. Cronbach's alpha coefficient of the questionnaire varied from 0.61 to 0.83 and test-retest coefficient was higher than 0.7. Correlation coefficient was between NMQ and body posture (r = 0.23, P = 0.004) and between NMQ and work environment (r = 0.28, P = 0.000). Evaluations related to the construct validity and concurrent validity demonstrated that the questionnaire has acceptable construct validity. Six factors of the MUEQ in Root Mean Squared Error Approximation (RMSEA) index (0.062) were acceptable and satisfactory in Parsimony Comparative Fit Index (PCFI), Comparative Fit Index (CFI), Normed Fit Index (NFI), and Parsimony Goodness of Fit Index (PGFI) (0.732, 0.8000, 0.680, and 0.680, respectively).

CONCLUSIONS

The Persian version of the MUEQ represented a satisfactory validity and reliability and was suitable for computer users in the assessment of their risk factors of musculoskeletal complaints.

Assessment of arm, neck and shoulder complaints and scapular static malposition among computer users

Background:

Musculoskeletal complaints of the arm, neck and/or shoulder not attributed to acute trauma or any systemic disorder (CANS) are characterized by symptoms such as pain, numbness and paresthesia which may reach severe and disabling levels and thus significantly interfere with the performance of work and daily living activities. Computer use at work considerably increased in recent years, being attended with a substantial elevation of the prevalence of CANS among individuals who use computers at work.

Objective:

To investigate biomechanical and psychosocial risk factors, scapular static imbalance and functional impact on work and daily living activities of upper limb complaints among workers who use computers.

Methods:

We analyzed ergonomic and psychosocial risk factors by means of MUEQ-Br, scapular static malposition with the SICK-scapula protocol, and functional impairment in work and daily living activities with DASH. The sample comprised 109 employees of a private institution who use computers at work.

Results:

The average scores on body posture and control over tasks were significantly higher among the symptomatic participants. Scapular malposition did not differ between the symptomatic and asymptomatic participants, but functional impairment did.

Conclusion:

Awkward posture at work and poor control over tasks seem to contribute to the occurrence of CANS among office workers who use computers. Scapular malposition is not systematically present among individuals with CANS, but the opposite is true. Individuals with CANS exhibited functional impairments.

Self-Estimated Functional Inability because of Pain questionnaire for Brazilian workers with musculoskeletal pain: face and content validity

ABSTRACT Our study aimed to perform the face and content validity of Self-Estimated Functional Inability because of Pain (SEFIP) for workers, here called the SEFIP-work questionnaire. This is a questionnaire validity study. Our group previously translated and adapted the original version of the SEFIP, which was developed to investigate musculoskeletal pain and dysfunction to be applied to dancers (SEFIP-dance). However, due to the broad scope of the SEFIP-dance, we made changes and adaptations in the Brazilian Portuguese version of the SEFIP-dance to allow its use in workers. Therefore, face and content validity were performed for the development of the SEFIP-work based on opinions of committee of occupational disease and rehabilitation experts. After face and content validity, this SEFIP-work version was applied to 30 working individuals with musculoskeletal pain. The participants were native Brazilian Portuguese speakers aged 18 years and older. Thus, three changes were made to the questionnaire. All participants understood the SEFIP-work items and alternatives. The average total SEFIP-work score was 6.59 (SD=3.66), with the item “parte inferior das costas” (lower back) being the most marked (n=28; 93.33%), with an average score of 1.18 (SD=0.73). In conclusion, the Brazilian Portuguese version of SEFIP-work presents an acceptable level of understanding by workers in the investigation of musculoskeletal pain or discomfort.

The Richards-Campbell Sleep Questionnaire and Sleep in the Intensive Care Unit Questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil

Objective:

To translate the Richards-Campbell Sleep Questionnaire (RCSQ) and Sleep in the Intensive Care Unit Questionnaire (SICUQ) to Portuguese, making the appropriate cross-cultural adaptations for their use in Brazil, as well as to determine the interobserver reliability of the instruments.

Methods:

In this study, we evaluated medical and surgical patients admitted to the adult ICU of the Federal University of Paraná Hospital de Clínicas, in the city of Curitiba, Brazil, between June of 2017 and January of 2018. The translation and cross-cultural adaptation of the questionnaires involved the following steps: translation, synthesis, back-translation, revision by an expert panel, approval of the back-translation by the original authors, pretesting, and creation of the final versions. Two researchers applied the Portuguese-language versions in the evaluation of critically ill patients. Interobserver reliability was assessed by calculating the intraclass correlation coefficient (ICC) and 95% CI.

Results:

The sample comprised 50 patients, of whom 27 (54%) were women. The mean age was 47.7 ± 17.5 years. The main reason for ICU admission, in 10 patients (20%), was cancer. The interobserver reliability of the questionnaires ranged from good to excellent. For the RCSQ, the ICC was 0.84 (95% CI: 0.71-0.90). For SICUQ domains 1-5 (sleep quality and daytime sleepiness), the ICC was 0.75 (95% CI: 0.55-0.86), whereas it was 0.86 (95% CI: 0.76-0.92) for SICUQ domains 6 and 7 (causes of sleep disruption).

Conclusions:

The cross-culturally adapted, Portuguese-language versions of the RCSQ and SICUQ appear to have good interobserver reliability.

Rapid office strain assessment (ROSA): Cross cultural validity, reliability and structural validity of the Brazilian-Portuguese version

Forty-three occupational health professionals (observers) and 90 workers were enrolled in this study to perform the cross-cultural adaptation of the Rapid Office Strain Assessment into Brazilian Portuguese (ROSA-Br) and evaluate its psychometric properties. After cross-cultural adaptation, the measurement properties were checked in three stages: study 1: pre-testing (27 observers rated 15 office worker videos), study 2: intra- and inter-observer reliability (26 observers rated 15 office worker videos), and study 3: validity and accuracy of ROSA-Br final scores (90 office workers). For the ROSA scores, acceptable intraclass correlation coefficients were found for 75% and 86% of the intra-observer reliability comparisons for non-trained and trained observers, respectively, and for 100% of the inter-observer reliability comparisons (0.43-0.86). For construct validity, moderate correlations were observed for 70% of the comparisons between ROSA final scores and other ergonomic instruments. Moderate accuracy was observed for a ROSA-Br final score of 6 (AUC [area under the curve] = 0.72, 0.89). Taken together, these results support the use of the ROSA-Br for ergonomic field assessments and research.

Prevalence of complaints of arm, neck, and shoulders among computer professionals in Bangalore: A cross-sectional study

INTRODUCTION

Complaints of arm, neck, and shoulders (CANS) is a common problem among patients whose work involves computer use, but often ignored most importantly by the physicians partly due to not being able to appreciate the importance of taking a careful detailed occupational history of exposure to a repetitive activity involving upper arms. Upper extremity musculoskeletal disorders constitute a major portion of occupation-related illness with annual costs related to treatment and absenteeism from work ranging between $45 and 54 billion in the United States.

MATERIALS AND METHODS

A cross-sectional study was done to assess the factors contributing to CANS among computer professionals in Bangalore. We screened 206 professionals and 181 were administered Maastricht Upper Extremity Questionnaire (MUEQ). Chi-square and logistic regression were used.

RESULTS

Prevalence of CANS in the study group was 58.6%. Neck complaints topped the list followed by shoulder, wrist, hand, elbow, upper arm, and lower arm complaints in the descending order. Women had overall higher prevalence and significantly higher prevalence of upper limb complaints than men. Inadequate space, maintaining good posture, and repetition of same tasks have emerged as an independent factors associated with CANS.

CONCLUSION

CANS is highly prevalent among computer professionals working in small and medium-sized companies. Provision of adequate workspace and ergonomic designs of workstations are the modifiable risk factors which can be addressed by the employers to reduce the morbidity associated with CANS. Employees could correct postures and improve work habits.

Brazilian version of the Functional Status Score for the ICU: translation and cross-cultural adaptation

Objective

The aim of the present study was to translate and cross-culturally adapt the Functional Status Score for the intensive care unit (FSS-ICU) into Brazilian Portuguese.

Methods

This study consisted of the following steps: translation (performed by two independent translators), synthesis of the initial translation, back-translation (by two independent translators who were unaware of the original FSS-ICU), and testing to evaluate the target audience's understanding. An Expert Committee supervised all steps and was responsible for the modifications made throughout the process and the final translated version.

Results

The testing phase included two experienced physiotherapists who assessed a total of 30 critical care patients (mean FSS-ICU score = 25 ± 6). As the physiotherapists did not report any uncertainties or problems with interpretation affecting their performance, no additional adjustments were made to the Brazilian Portuguese version after the testing phase. Good interobserver reliability between the two assessors was obtained for each of the 5 FSS-ICU tasks and for the total FSS-ICU score (intraclass correlation coefficients ranged from 0.88 to 0.91).

Conclusion

The adapted version of the FSS-ICU in Brazilian Portuguese was easy to understand and apply in an intensive care unit environment.