a systematic review of observational studies

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Self-reported variables as determinants of upper limb musculoskeletal symptoms in assembly line workers

Background: Assembly lines work is frequently associated to work-related upper limb musculoskeletal disorders. The related disability and absenteeism make it important to implement efficient health surveillance systems. The main objective of this study was to identify self-reported variables that can determine work-related upper limb musculoskeletal symptoms—discomfort/pain–during a 6-month follow-up. Methods: This was a prospective study with a 6-month follow-up period, performed in an assembly line. Upper limb musculoskeletal discomfort/pain was assessed through the presence of self-reported symptoms. Uni- and multivariate logistic regression analyses were used to evaluate which self-reported variables were associated to upper limb symptoms after 6 months at the present and to upper limbs symptoms in the past month. Results: Of the 200 workers at baseline, 145 replied to the survey after 6 months. For both outcomes, “having upper limb symptoms during the previous 6 months” and “education” were possible predictors. Conclusion: Our results suggest that having previous upper limb symptoms was related to its maintenance after 6 months, sustaining it as a specific determinant. It can be a hypothesis that this population had mainly workers with chronic symptoms, although our results give only limited support to self-reported indicators as determinants for upper limb symptoms. Nevertheless, the development of an efficient health surveillance system for high demanding jobs should implicate self-reported indicators, but also clinical and work conditions assessment should be accounted on the future.publishersversionpublishe

results from a nationwide population-based study

Funding Information: This study is funded by national funds through FCT - Fundação para a Ciência e Tecnologia, I. P. under the PhD grant SFRH/BD/148420/2019 awarded to the first author. This protocol was included in the PhD previously approved project. EpiReumpaPt was supported by unrestricted grants from Direcção-Geral da Saúde, Fundação Calouste Gulbenkian, Fundação Champalimaud, Fundação AstraZeneca, AbbVie, Merck, Sharp & Dohme, Pfizer, Roche, Servier, Bial, D3A Medical Systems, Happybrands, Center de Medicina Laboratorial Germano de Sousa, Clínica Médica da Praia da Vitória, CAL-Clínica, Galp Energia, Açoreana Seguros, and individual rheumatologists.Background: Worldwide, the current management of knee osteoarthritis appears heterogeneous, high-cost and often not based on current best evidence. The absence of epidemiological data regarding the utilisation of healthcare services may conceal the need for improvements in the management of osteoarthritis. The aim of this study is to explore the profiles of healthcare services utilisation by people with knee osteoarthritis, and to analyse their determinants, according to Andersen’s behavioural model. Methods: We analysed a sample of 978 participants diagnosed with knee osteoarthritis from the population-based study EpiReumaPt, in Portugal. Data was collected with a structured interview, and the diagnosis of knee osteoarthritis was validated by a rheumatologist team. With the Two-step Cluster procedure, we primarily identified different profiles of healthcare utilisation according to the services most used by patients with knee osteoarthritis. Secondly, we analysed the determinants of each profile, using multinomial logistic regression, according to the predisposing characteristics, enabling factors and need variables. Results: In our sample, a high proportion of participants are overweight or obese (82,6%, n = 748) and physically inactive (20,6%, n = 201) and a small proportion had physiotherapy management (14,4%, n = 141). We identified three profiles of healthcare utilisation: “HighUsers”; “GPUsers”; “LowUsers”. “HighUsers” represents more than 35% of the sample, and are also the participants with higher utilisation of medical appointments. “GPUsers” represent the participants with higher utilisation of general practitioner appointments. Within these profiles, age and geographic location – indicated as predisposing characteristics; employment status and healthcare insurance - as enabling factors; number of comorbidities, physical function, health-related quality of life, anxiety and physical exercise - as need variables, showed associations (p < 0,05) with the higher utilisation of healthcare services profiles. Conclusions: Healthcare utilisation by people with knee osteoarthritis is not driven only by clinical needs. The predisposing characteristics and enabling factors associated with healthcare utilisation reveal inequities in the access to healthcare and variability in the management of people with knee osteoarthritis. Research and implementation of whole-system strategies to improve equity in the access and quality of care are paramount in order to diminish the impact of osteoarthritis at individual-, societal- and economic-level.publishersversionpublishe

Effects of Glyphosate-Based Herbicide on Primary Production and Physiological Fitness of the Macroalgae Ulva lactuca

The use of glyphosate-based herbicides (GBHs) worldwide has increased exponentially over the last two decades increasing the environmental risk to marine and coastal habitats. The present study investigated the effects of GBHs at environmentally relevant concentrations (0, 10, 50, 100, 250, and 500 g L1) on the physiology and biochemistry (photosynthesis, pigment, and lipid composition, antioxidative systems and energy balance) of Ulva lactuca, a cosmopolitan marine macroalgae species. Although GBHs cause deleterious effects such as the inhibition of photosynthetic activity, particularly at 250 g L1, due to the impairment of the electron transport in the chloroplasts, these changes are almost completely reverted at the highest concentration (500 g L1). This could be related to the induction of tolerance mechanisms at a certain threshold or tipping point. While no changes occurred in the energy balance, an increase in the pigment antheraxanthin is observed jointly with an increase in ascorbate peroxidase activity. These mechanisms might have contributed to protecting thylakoids against excess radiation and the increase in reactive oxygen species, associated with stress conditions, as no increase in lipid peroxidation products was observed. Furthermore, changes in the fatty acids profile, usually attributed to the induction of plant stress response mechanisms, demonstrated the high resilience of this macroalgae. Notably, the application of bio-optical tools in ecotoxicology, such as pulse amplitude modulated (PAM) fluorometry and laser-induced fluorescence (LIF), allowed separation of the control samples and those treated by GBHs in different concentrations with a high degree of accuracy, with PAM more accurate in identifying the different treatmentsinfo:eu-repo/semantics/publishedVersio

Scapular dynamic muscular stiffness assessed through myotonometry: a narrative review

Several tools have been used to assess muscular stiffness. Myotonometry stands out as an accessible, handheld, and easy to use tool. The purpose of this review was to summarize the psychometric properties and methodological considerations of myotonometry and its applicability in assessing scapular muscles. Myotonometry seems to be a reliable method to assess several muscles stiffness, as trapezius. This method has been demonstrated fair to moderate correlation with passive stiffness measured by shear wave elastography for several muscles, as well as with level of muscle contraction, pinch and muscle strength, Action Research Arm Test score and muscle or subcutaneous thickness. Myotonometry can detect scapular muscles stiffness differences between pre- and post-intervention in painful conditions and, sometimes, between symptomatic and asymptomatic subjects.info:eu-repo/semantics/publishedVersio

findings from a scoping review on models of care

Funding Information: This project is supported by FCT\u2014Funda\u00E7\u00E3o para a Ci\u00EAncia e a Tecnologia, I.P., under the PhD grant awarded to STD (UI/BD/150882/2021) and the MyBack project (PTDC/SAU-SER/7406/2020), in which EBC is the principal investigator. Publisher Copyright: © 2024 BMJ Publishing Group. All rights reserved.Introduction Models of care (MoCs) describe evidence-informed healthcare that should be delivered to patients. Several MoCs have been implemented for low back pain (LBP) to reduce evidence-to-practice gaps and increase the effectiveness and sustainability of healthcare services. Objective To synthesise research evidence regarding core characteristics and key common elements of MoCs implemented in primary healthcare for the management of LBP. Design Scoping review. Data sources Searches on MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, PEDro, Scopus, Web of Science and grey literature databases were conducted. Eligibility criteria Eligible records included MoCs implemented for adult LBP patients in primary healthcare settings. Data extraction and synthesis Data extraction was carried out independently by two researchers and included a summary of the studies, the identification of the MoCs and respective key elements, concerning levels of care, settings, health professionals involved, type of care delivered and core components of the interventions. Findings were investigated through a descriptive qualitative content analysis using a deductive approach. Results 29 studies reporting 11 MoCs were included. All MoCs were implemented in high-income countries and had clear objectives. Ten MoCs included a stratified care approach. The assessment of LBP patients typically occurred in primary healthcare while care delivery usually took place in community-based settings or outpatient clinics. Care provided by general practitioners and physiotherapists was reported in all MoCs. Education (n=10) and exercise (n=9) were the most common health interventions. However, intervention content, follow-ups and discharge criteria were not fully reported. Conclusions This study examines the features of MoCs for LBP, highlighting that research is in its early stages and stressing the need for better reporting to fill gaps in care delivery and implementation. This knowledge is crucial for researchers, clinicians and decision-makers in assessing the applicability and transferability of MoCs to primary healthcare settings.publishersversionpublishe

A Cross-Sectional Population-Based Study

Funding Information: We thank the EpiDoc Unit and EpiReumaPt team for conceptualising, planning, and implementing the main research project. We would like to acknowledge that the present publication was supported by Fundação Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020). Funding Information: This work was supported by an independent research grant from Pfizer. DC received national funding through FCT—Fundação para a Ciência e Tecnologia, I. P. under the Ph.D. grant SFRH/BD/148420/2019Background: Hip/knee osteoarthritis (HKOA) is a leading cause of disability and imposes a major socioeconomic burden. The aim of this study is to estimate the prevalence of HKOA in Portugal, characterised the clinical severity of HKOA in the population, and identified sociodemographic, lifestyle, and clinical factors associated with higher clinical and radiographic severity. Methods: Participants with a diagnosis of HKOA from the EpiReumaPt study (2011–2013) were included (n = 1,087). Hip/knee osteoarthritis diagnosis was made through a structured evaluation by rheumatologists according to American College of Rheumatology criteria. Clinical severity was classified based on Hip Disability and Osteoarthritis Outcome Scale (HOOS) and Knee Injury and Osteoarthritis Outcome Scale (KOOS) score tertiles. Radiographic severity was classified based on the Kellgren-Lawrence grades as mild, moderate, or severe. Sociodemographic lifestyle and clinical variables, including the presence of anxiety and depression symptoms, were analysed. Factors associated with higher clinical and radiographic severity were identified using ordinal logistic regression models. Results: Hip/knee osteoarthritis diagnosis was present in 14.1% of the Portuguese population [12.4% with knee osteoarthritis (OA) and 2.9% with hip OA]. Clinical severity was similar between people with hip (HOOS = 55.79 ± 20.88) and knee (KOOS = 55.33 ± 20.641) OA. People in the high HOOS/KOOS tertile tended to be older (64.39 ± 0.70 years), female (75.2%), overweight (39.0%) or obese (45.9%), and had multimorbidity (86.1%). Factors significantly associated with higher clinical severity tertile were age [55–64 years: odds ratio (OR) = 3.18; 65–74 years: OR = 3.25; ≥75 years: OR = 4.24], female sex (OR = 1.60), multimorbidity (OR = 1.75), being overweight (OR = 2.01) or obese (OR = 2.82), and having anxiety symptoms (OR = 1.83). Years of education was inversely associated with higher clinical severity. Factors significantly associated with higher radiographic severity were age (65–74 years: OR = 3.59; ≥75 years: OR = 3.05) and being in the high HOOS/KOOS tertile (OR = 4.91). Being a female and live in Lisbon or in the Centre region were inversely associated with the higher radiographic severity. Conclusion: Hip/knee osteoarthritis is present in ~1.1 million of Portuguese people. Age, educational level, and obesity are independently associated with HKOA clinical severity, whereas age, sex, geographic location, and clinical severity are independently associated with radiographic severity.publishersversionpublishe

Vineyard pruning waste as an alternative carbon source to produce novel biosurfactants by Lactobacillus paracasei

Abstract Cellulosic sugars extracted from vineyard pruning waste (VPW) were used as a low-cost carbon source for biosurfactant production by Lactobacillus paracasei. The results obtained showed that when glucose from VPW was used, the biosurfactant was a glycolipopeptide, whereas when it was replaced by lactose the biosurfactant produced was a glycoprotein. Additionally, it was found that the extraction process, either with phosphate-buffer or phosphate-buffer saline, influenced the biosurfactant chemical structure and emulsion capacity. Overall, these results highlight the possibility of producing biosurfactants à la carte with the same strain but changing the carbon source, increasing its potential in different industrial applications.This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit, COMPETE 2020 (POCI-01-0145-FEDER-006684) and the project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462), as well as X. Vecino post-doctoral grant (SFRH/BPD/101476/2014). The authors also acknowledge financial support from BioTecNorte operation (NORTE-01-0145-FEDER-000004) and the project MultiBiorefinery (POCI-01-0145-FEDER-016403) funded by the European Regional Development Fund under the scope of Norte2020—Programa Operacional Regional do Norte and the Post-doctoral grant CEB-BPD/01/2015/07 from the project UID/BIO/04469/2013, funded by FCT, to E. Gudiña. Additionally, the authors acknowledge the financial support from Spanish Ministry of Economy and Competitiveness (FEDER funds under the project CTM2015-68904) and L. Rodríguez-López acknowledges to the Spanish Ministry of Education, Culture and Sport for her pre-doctoral fellowship (FPU15/00205).info:eu-repo/semantics/publishedVersio

Scapular motor control and upper limb movement quality in subjects with and without chronic shoulder pain

Despite the existence of several studies about the scapula’s position and motion, in shoulder pain conditions, there are still conflicting findings regarding scapular adaptations and reduced research about the scapula’s role during functional tasks. The present study aimed to compare scapular-related kinematic and electromyographic outcomes during different shoulder movements (with and without load) and the drinking task, between symptomatic and asymptomatic subjects. Forty subjects (divided into two groups) participated in this cross-sectional observational study. Scapulothoracic motion, scapulohumeral rhythm, and movement quality (considering trunk compensation, time-to-peak acceleration, and smoothness), as well as the relative surface electromyographic activity and muscle ratio considering the trapezius, serratus anterior, and levator scapulae (LS), were assessed. The symptomatic group presented the following: (1) changes in scapular upward rotation (p = 0.008) and winging (p = 0.026 and p = 0.005) during backward transport and drink phases; (2) increased muscle activity level of the middle trapezius (MT) in all tasks (p < 0.0001 to p = 0.039), of LS during shoulder elevation with load (p = 0.007), and of LS and LT during most of the drinking task phases (p = 0.007 to p = 0.043 and p < 0.0001 to p = 0.014, respectively); (3) a decreased serratus anterior lower portion activity level (SAlow) during shoulder lowering with load (p = 0.030) and drink phase (p = 0.047); and (4) an increased muscular ratio between scapular abductors/adductors (p = 0.005 to p = 0.036) and elevators/depressors (p = 0.008 to p = 0.028). Compared to asymptomatic subjects, subjects with chronic shoulder pain presented scapular upward rotation and winging adaptations; increased activity levels of MT, LT, and LS; decreased activity levels of SAlow; and increased scapular muscle ratios.info:eu-repo/semantics/publishedVersio