Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: an analysis of cross-sectional survey data.

BackgroundPatient handling is a major risk factor for musculoskeletal injuries among nurses. Lifting equipment is a main component of safe patient handling programs that aim to prevent musculoskeletal injury. However, the actual levels of lift availability and usage are far from optimal.ObjectiveTo examine the effect of patient lifting equipment on musculoskeletal pain by level of lift availability and lift use among critical-care nurses.Design and participantsA cross-sectional postal survey of a random sample of 361 critical-care nurses in the United States.MethodsThe survey collected data on low-back, neck, and shoulder pain, lift availability, lift use, physical and psychosocial job factors, and sociodemographics. Musculoskeletal pain was assessed by three types of measures: any pain, work-related pain, and major pain. Multivariable logistic regressions were used to examine the associations between musculoskeletal pain and lift variables, controlling for demographic and job factors.ResultsLess than half (46%) of respondents reported that their employer provided lifts. Of 168 nurses who had lifts in their workplace, the level of lift availability was high for 59.5%, medium for 25.0%, and low for 13.7%; the level of lift use was high for 32.1%, medium for 31.5%, and low for 31.5%. Significant associations were found between lift availability and work-related low-back and shoulder pain. Compared to nurses without lifts, nurses reporting high-level lift availability were half as likely to have work-related low-back pain (OR=0.50, 95% CI 0.26-0.96) and nurses reporting medium-level lift availability were 3.6 times less likely to have work-related shoulder pain (OR=0.28, 95% CI 0.09-0.91). With respect to lift use, work-related shoulder pain was three times less common among nurses reporting medium-level use (OR=0.33, 95% CI 0.12-0.93); any neck pain was three times more common among nurses reporting low-level use (OR=3.13, 95% CI 1.19-8.28).ConclusionsGreater availability and use of lifts were associated with less musculoskeletal pain among critical-care nurses. These findings suggest that for lift interventions to be effective, lifts must be readily available when needed and barriers against lift use must be removed

Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: an analysis of cross-sectional survey data.

BackgroundPatient handling is a major risk factor for musculoskeletal injuries among nurses. Lifting equipment is a main component of safe patient handling programs that aim to prevent musculoskeletal injury. However, the actual levels of lift availability and usage are far from optimal.ObjectiveTo examine the effect of patient lifting equipment on musculoskeletal pain by level of lift availability and lift use among critical-care nurses.Design and participantsA cross-sectional postal survey of a random sample of 361 critical-care nurses in the United States.MethodsThe survey collected data on low-back, neck, and shoulder pain, lift availability, lift use, physical and psychosocial job factors, and sociodemographics. Musculoskeletal pain was assessed by three types of measures: any pain, work-related pain, and major pain. Multivariable logistic regressions were used to examine the associations between musculoskeletal pain and lift variables, controlling for demographic and job factors.ResultsLess than half (46%) of respondents reported that their employer provided lifts. Of 168 nurses who had lifts in their workplace, the level of lift availability was high for 59.5%, medium for 25.0%, and low for 13.7%; the level of lift use was high for 32.1%, medium for 31.5%, and low for 31.5%. Significant associations were found between lift availability and work-related low-back and shoulder pain. Compared to nurses without lifts, nurses reporting high-level lift availability were half as likely to have work-related low-back pain (OR=0.50, 95% CI 0.26-0.96) and nurses reporting medium-level lift availability were 3.6 times less likely to have work-related shoulder pain (OR=0.28, 95% CI 0.09-0.91). With respect to lift use, work-related shoulder pain was three times less common among nurses reporting medium-level use (OR=0.33, 95% CI 0.12-0.93); any neck pain was three times more common among nurses reporting low-level use (OR=3.13, 95% CI 1.19-8.28).ConclusionsGreater availability and use of lifts were associated with less musculoskeletal pain among critical-care nurses. These findings suggest that for lift interventions to be effective, lifts must be readily available when needed and barriers against lift use must be removed

Psychosocial work factors in new or recurrent injuries among hospital workers: a prospective study

PurposeAccumulating evidence suggests an important role for psychosocial work factors in injury, but little is known about the interaction between psychosocial factors and previous injury experience on subsequent injury risk. We examined the relationships between psychosocial work factors and new or recurrent injury among hospital workers.MethodsWe studied 492 hospital workers including 116 cases with baseline injury and 376 injury-free referents at baseline over follow-up. Job strain, total support, effort-reward imbalance, overcommitment, and musculoskeletal injury at baseline were examined in logistic regression models as predictors of new or recurrent injury experienced during a 2-year follow-up period.ResultsThe overall cumulative incidence of injury over follow-up was 35.6 % (51.7 % for re-injury among baseline injury cases; 30.6 % for new injury among referents). Significantly increased risks with baseline job strain (OR 1.26; 95 % CI 1.02-1.55) and effort-reward imbalance (OR 1.42; 95 % CI 1.12-1.81) were observed for injury only among the referents. Overcommitment was associated with increased risk of injury only among the cases (OR 1.58; 95 % CI 1.05-2.39).ConclusionsThe effects of psychosocial work factors on new or recurrent injury risk appear to differ by previous injury experience, suggesting the need for differing preventive strategies in hospital workers

Job stress and work-related musculoskeletal symptoms among intensive care unit nurses: a comparison between job demand-control and effort-reward imbalance models.

BackgroundThe aims of this study were to compare job demand-control (JDC) and effort-reward imbalance (ERI) models in examining the association of job stress with work-related musculoskeletal symptoms and to evaluate the utility of a combined model.MethodsThis study analyzed cross-sectional survey data obtained from a nationwide random sample of 304 intensive-care unit (ICU) nurses. Demographic and job factors were controlled in the analyses using logistic regression.ResultsBoth JDC and ERI variables had strong and statistically significant associations with work-related musculoskeletal symptoms. Effort-reward imbalance had stronger associations than job strain or iso-strain with musculoskeletal symptoms. Effort-reward imbalance alone showed similar or stronger associations with musculoskeletal symptoms compared to combined variables of the JDC and ERI models.ConclusionsThe ERI model appears to capture the magnitude of the musculoskeletal health risk among nurses associated with job stress at least as well and possibly better than the JDC model. Our findings suggest that combining the two models provides little gain compared to using effort-reward imbalance only

Health and Safety Strategies of Urban Taxi Drivers

This study describes health and safety concerns and self-care strategies of San Francisco taxi drivers. Focus groups and a written cross-sectional survey were done in a convenience sample of taxi drivers working in San Francisco. Sessions were audiotaped, transcribed in English, and independently coded to identify major health and safety themes, using thematic content analysis. Strategies to manage health and safety issues are the focus of this analysis. Five focus groups were held in 2009 with 36 participants. Major health and safety themes included stress, body pain, danger, vulnerable employment status, and concerns related to unhealthy working conditions. Self-care strategies included diffusion/decompression to manage stress, maintaining a positive attitude, maintaining power and control, and practicing proactive self-care. Creative self-care strategies were described by taxi drivers to keep healthy and safe at work. These data will inform future self-care interventions to reduce health and safety risks of taxi driving

Solution structure of Ca2+-free rat α-parvalbumin

Mammals express two parvalbumins—an α isoform and a β isoform. In rat, the α-parvalbumin (α-PV) exhibits superior divalent ion affinity. For example, the standard free energies for Ca2+ binding differ by 5.5 kcal/mol in 0.15 M KCl (pH 7.4). High-resolution structures of the Ca2+-bound proteins provide little insight into this disparity, prompting a structural analysis of the apo-proteins. A recent analysis of rat β-PV suggested that Ca2+ removal provokes substantial conformational changes—reorientation of the C, D, and E helices; reorganization of the hydrophobic core; reduced interdomain contact; and remodeling of the AB domain. The energetic penalty attendant to reversing these changes, it was suggested, could contribute to the attenuated divalent ion-binding signature of that protein. That hypothesis is supported by data presented herein, describing the solution structure and peptide backbone dynamics of Ca2+-free rat α-PV. In marked contrast to rat β-PV, the apo- and Ca2+-loaded forms of the rat α isoform are quite similar. Significant structural differences appear to be confined to the loop regions of the molecule. This finding implies that the α-PV isoform enjoys elevated divalent ion affinity because the metal ion-binding events do not require major structural rearrangement and the concomitant sacrifice of binding energy