Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners

<p>Abstract</p> <p>Background</p> <p>Only a few workplace initiatives among cleaners have been reported, even though they constitute a job group in great need of health promotion. The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain, work ability and sickness absence among cleaners.</p> <p>Methods</p> <p>A cluster-randomised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training (PCT), cognitive behavioural training (CBTr) or a reference group (REF). Questionnaires about musculoskeletal pain and work ability were completed at baseline and after one year's intervention. Sickness absence data were obtained from the managers' records. Analyses were performed according to the intention-to-treat-principle (ITT).</p> <p>Results</p> <p>No overall reduction in musculoskeletal pain, work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses. However, explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT. People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF (p = 0.05).</p> <p>Conclusions</p> <p>The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners. It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN96241850">ISRCTN96241850</a></p

Low back pain and widespread pain predict sickness absence among industrial workers

BACKGROUND: The prevalence of musculoskeletal disorders (MSD) in the aluminium industry is high, and there is a considerable work-related fraction. More knowledge about the predictors of sickness absence from MSD in this industry will be valuable in determining strategies for prevention. The aim of this study was to analyse the relative impact of body parts, psychosocial and individual factors as predictors for short- and long-term sickness absence from MSD among industrial workers. METHODS: A follow-up study was conducted among all the workers at eight aluminium plants in Norway. A questionnaire was completed by 5654 workers at baseline in 1998. A total of 3320 of these participated in the follow-up study in 2000. Cox regression analysis was applied to investigate the relative impact of MSD in various parts of the body and of psychosocial and individual factors reported in 1998 on short-term and long-term sickness absence from MSD reported in 2000. RESULTS: MSD accounted for 45% of all working days lost the year prior to follow-up in 2000. Blue-collar workers had significantly higher risk than white-collar workers for both short- and long-term sickness absence from MSD (long-term sickness absence: RR = 3.04, 95% CI 2.08–4.45). Widespread and low back pain in 1998 significantly predicted both short- and long-term sickness absence in 2000. In addition, shoulder pain predicted long-term sickness absence. Low social support predicted short-term sickness absence (RR = 1.28, 95% CI 1.11–1.49). CONCLUSIONS: Reducing sickness absence from MSD among industrial workers requires focusing on the working conditions of blue-collar workers and risk factors for low back pain and widespread pain. Increasing social support in the work environment may have effects in reducing short-term sickness absence from MSD

Att skapa läroplan för de yngsta barnen i förskolan. Barns perspektiv och nuets didaktik

This thesis takes as one point of departure the concept of the expanded curriculum where curricula encompass both the formal steering documents, as well as that which goes on within the framework of preschool education and through the actors in preschools. The overarching purpose is therefore to generate knowledge about what conditions for learning the work of teachers make possible when curricula are created in preschool settings for children aged between 1 and 3. The purpose is also to contribute with knowledge about what these created curricula would mean for children’s agency, and the importance they can have for children’s opportunities for learning and development. The three empirical studies consist of digitally recorded interviews with teachers and video observations with a focus on teachers’ communication with children in preschool. The discussion in the overarching text is constructed around three aspects that emerge in the overall results of the studies. First, the studies reveal how teachers’ work can be likened to a limiting curriculum which, on the one hand, is entirely child-centered, with the children as seen actors, but, on the other, can be interpreted as entirely teacher-centered. Secondly, there is the discussion about the affirmative curriculum, where children are presented as affirmed actors. In other words, content becomes those things that children are interested in, and their modes of expression are seen, affirmed and often repeated. Finally there is the discussion about the possibilities and dilemmas related to an expanding curriculum where children are regarded and treated as real actors in the sense that their intentions and expressions are taken seriously as relevant challenges. The current curriculum text for Swedish preschool can, in this sense, be seen as an obstacle in that its formulations are extremely broad-based, as discussed related to the results of this thesis