Managers attitude towards implementing workplace health promotion programmes to employees in eldercare: a cross-sectional study

Objectives: To determine the attitudes of eldercare services managers to the potential health benefits of workplace health promotion programmes (WHPPs), including physical exercise during working hours and the feasibility of implementing a WHPP at the workplace.Study design: A cross-sectional study.Methods: Respondents filled out a 14-item questionnaire on attitudes towards the potential health benefits of WHPPs and the feasibility of implementing WHPPs. Differences between groups were analysed using the Kruskal-Wallis test. The significance level was set to p ​= ​0.05. Bonferroni's correction was used in the setting of multiple comparisons. A content analysis was performed exploring answers provided in the optional comment section in the questionnaire.Results: 695 eldercare services managers in Denmark were contacted by email, 393 replied, and 382 respondents were included in the analysis (54.7%). The survey revealed that 89.8% of the respondents believed that WHPPs would increase health, 89.6% believed that it would increase well-being and 87.6% believed that WHPPs would increase workability among workers. 87.7% expressed a willingness towards implementing WHPPs and believed 'it to be a good idea'. Respondents with a negative attitude to the feasibility of implementing WHPPs, were more likely to hold negative attitudes to the potential health benefits of WHPPs (p ​&lt; ​0.001). Organisational issues were the most frequently stated barrier to implementation.Conclusions: The majority of eldercare managers expressed a positive attitude to the benefits of WHPPs and their implementation. Addressing organisational issues and ensuring management support in the planning stage of a WHPP is highly important.</p

Muscle function following testosterone replacement in men on opioid therapy for chronic non-cancer pain:A randomized controlled trial

BACKGROUND: Chronic pain and opioid treatment are associated with increased risk of male hypogonadism and subsequently decreased muscle function. A diagnosis of hypogonadism is based on the presence of low total testosterone and associated symptoms. The effect of testosterone replacement therapy on muscle function in men with chronic pain and low total testosterone remains to be investigated.OBJECTIVES: To investigate the effects of testosterone replacement therapy on muscle function and gait performance in men treated with opioids for chronic non-cancer pain.MATERIALS AND METHODS: A double-blind, placebo-controlled study. Forty-one men (&gt;18 years) with opioid-treated chronic pain and serum total testosterone &lt; 12 nmol/L were randomized to 24 weeks testosterone replacement therapy (testosterone undecanoate injection three times/6 months, n  = 20) or placebo injections (n  = 21). Muscle function was measured as leg press maximal voluntary contraction, leg extension power using the Nottingham power rig and handgrip strength using a handheld dynameter. Gait performance was measured at usual and maximal gait speed on a 10-m track. Body composition (lean body mass and fat mass) was determined by dual-energy X-ray absorptiometry. Mann-Whitney tests were performed on ∆-values (24-0 weeks) between testosterone replacement therapy and placebo.RESULTS: At baseline, median (interquartile range) age was 55 ± 13 years and BMI was 30.7 ± 5.2 kg/m2 . ∆-muscle function and ∆-gait performance were similar between testosterone replacement therapy and placebo. Median ∆-leg press maximal voluntary contraction was 174.2 ± 406.7 Newton, following testosterone replacement therapy, and 7.6 ± 419.1 Newton, after placebo, p = 0.091. ∆-lean body mass was significantly higher following testosterone replacement therapy compared to placebo, 3.6 ± 2.7 versus 0.1 ± 3.5 kg, respectively (p &lt; 0.001).DISCUSSION: Testosterone replacement therapy, compared to placebo, did not improve muscle function or gait performance despite increased lean body mass. Changes in body composition did not infer any changes in muscle function.CONCLUSION: 24 weeks testosterone replacement therapy in opioid-treated men with pain-related male hypogonadism did not improve muscle function.</p

Daily Life Coping:Helping stress-afflicted people manage everyday activities

BACKGROUND: Symptoms of stress are widespread in the working population and associated with long-term sickness absence and poor work functioning. Occupational therapy (OT)-based interventions are effective in improving return-to-work (RTW)-rates in stress-afflicted long-term sickness benefit beneficiaries (SBBs). No Danish standard on OT-RTW for stress-afflicted SSBs exists.AIMS: To describe and evaluate the feasibility of a seven-week OT-RTW intervention for stress-afflicted SBBs.MATERIALS AND METHODS: Daily Life Coping (DLC) utilizes peer-learning and salutogenetic perspectives to address occupational imbalances experienced by long-term SBBs. Stress-afflicted SBBs ( n  = 54) in the municipality of Hilleroed were enrolled. Self-efficacy and well-being were measured before and after intervention using the general self-efficacy (GSE) scale and WHO-5 Well-Being Index (WHO-5). RTW-rates were measured at one-year follow-up. Participant feedback was collected using standardized evaluation forms. RESULTS: Following the intervention, WHO-5 improved by 13.7 ± 16.5 points and GSE improved by 4.3 ± 4.8 points. Participant feedback was positive. At one-year follow-up, employment status data were available for 51 SSBs of these 58.8% achieved employment. High post-test GSE and WHO-5 scores were associated with employment at follow-up.CONCLUSION: DLC led to significant improvements in self-efficacy and well-being. Preliminary results indicate benefits on RTW-rates.SIGNIFICANCE: This study provides evidence of the feasibility of DLC in a municipal setting.</p

Correlates of localized musculoskeletal pain in overweight female health care professionals

Objectives: The risk of musculoskeletal pain increases when there is an imbalance between work demands and physical capacity. Work in elder care requires frequent periods of high mechanical loading. Body weight can further amplify this load, while muscle strength may lessen the relative strain on the musculoskeletal system. The purpose of this study was to assess the correlation between body composition, muscular strength and localized musculoskeletal pain intensity in overweight female health care professionals. Methods: A sample of 139 overweight female health care professionals working in elder care were included in the analyses. Associations between BMI, fat percentage, waist circumference, muscle strength and localized pain intensity were assessed using Kendall’s rank correlation. Results: Significant associations were found between musculoskeletal pain in the right shoulder and BMI (rτ=0.194; p=0.035), whereas upper back pain was associated with fat percentage and waist circumference (rτ=0.212; p=0.023 and rτ=0.212; p=0.024, respectively). Conclusions: Results indicate high BMI, fat percentage, and waist circumference may be contributing factors of localized musculoskeletal pain intensity of the upper body in overweight female health care professionals. These results may help guide the design of future workplace health promotion programmes

Dual-laboratory validation of a method for the determination of fructans in infant formula and adult nutritionals.

Until recently, only two AOAC Official MethodsSM have been available for the analysis of fructans: Method 997.08 and Method 999.03. Both are based on the analysis of the fructan component monosaccharides (glucose and fructose) after hydrolysis. The two methods have some limitations due to the strategies used for removing background interferences (such as from sucrose, α-glucooligosaccharides, and free sugars). The method described in this paper has been developed to overcome those limitations. The method is largely based on Method 999.03 and uses combined enzymatic and SPE steps to remove the interfering components without impacting the final analytical result. The method has been validated in two laboratories on infant formula and adult nutritionals. Recoveries were in the range of 86-119%, with most being in the range of 91-104%. RSDr values were in the range of 0.7-2.6%, with one exception when the fructan concentration was close to the LOQ, resulting in an RSDr of 8.9%. The performance is generally within the requirements outlined in the AOAC Standard Method Performance Requirements (SMPR® 2014.002), which specifies recoveries in the range of 90-110% and RSDr values below 6%