Effects of consecutive workdays and days off on low back pain, fatigue and stress:Prospective cohort study among warehouse and construction workers

Objectives Limited knowledge exists about day-to-day changes in physical and mental symptoms in warehouse and construction workers. This study investigated the associations between consecutive workdays and days off with low back pain (LBP) intensity, bodily fatigue and mental stress. Methods Participants (n=224) received daily questions for 21 days about LBP, fatigue, stress (outcome, 0-10 scales), and workdays and days off (exposure). We tested associations between 1-3 workdays (n=148) and 1-2 days off (n=158) with LBP intensity, bodily fatigue and mental stress after work and the following morning using linear mixed models with repeated measures controlling for relevant confounders. Results Consecutive workdays led to progressively increased LBP intensity, with three workdays increasing LBP intensity by 1.76 (95% CI 1.48 to 2.03) points. Bodily fatigue and mental stress increased after one workday (2.06 (95% CI 1.80 to 2.32) and 0.97 (95% CI 0.77 to 1.17) points, respectively) and remained stable for three workdays. After 1 day off, bodily fatigue and mental stress decreased -1.82 (95% CI -2.03 to -1.61) and -0.88 (95% CI -1.05 to -0.71) points, respectively, without decreasing further. In contrast, LBP intensity decreased progressively -1.09 (95% CI -1.27 to -0.91) and -1.45 (95% CI -1.67 to -1.24) points after 1 and 2 days off, respectively. Conclusions Workdays and days off affected the outcome variables differently. LBP intensity progressively increased with consecutive workdays, while workers needed 2 days off to recover. This study provides valuable knowledge about how to organise the workweek to prevent LBP, fatigue and stress, potentially reducing labour market withdrawal.</p

Attenuated lower limb stretch-shorten-cycle capacity in ACL injured vs. non-injured female alpine ski racers: Not just a matter of between-limb asymmetry

A retrospective analysis of routine countermovement jump (CMJ) testing, a coupled eccentric-concentric (stretch-shorten-cycle: SSC) movement, was performed in female elite alpine skiers with anterior cruciate ligament (ACL) reconstruction (ACLR) and without ACLR. A total of 567 tests obtained from the daily training environment were analyzed in 41 elite female athletes (non-injured control: n = 30, ACLR: n = 17), including n = 6 athletes with pre-injury data, between 16 and 32 years of age from alpine ski racing (n = 32) and skier cross (n = 9). Bilateral CMJ testing was conducted on a dual force plate system, and the limb-specific vertical ground reaction force (Fz) was analyzed to obtain the net eccentric deceleration impulse (Ecc), lower limb stiffness (Stiff), maximal vertical jump height (JH), peak external mechanical power (PP) exerted on the body center of mass (BCM), modified-reactive-strength-index (RSImod), and the loss in BCM velocity during the final phase of the takeoff Δ(Vmax–Vtakeoff). Eccentric and concentric phase-specific between-limb asymmetry indexes (AIs) were also calculated. Additive mixed effects models (AMMs) were used to compare the age-dependent and post-injury time course change between groups. The mean values for non-injured controls \u3e25 years of age were used as a comparative benchmark for recovery given the absence of pre-injury data. Net eccentric deceleration impulse increased and Δ(Vmax–Vtakeoff) decreased with age for the non-injured control group (p \u3c 0.001) while between-limb AI (mean ± SD) fell between 1 ± 5% for the concentric phase and 3 ± 7% for the eccentric deceleration phase. Between-limb asymmetry became smaller in ACLR skiers with time-from-surgery to reach non-injured control values by 2 years, but SSC function, such as JH and PP, remained depressed up to 5 years post-surgery (p \u3c 0.01), indicating impairments in SSC function. This highlights the importance of evaluating SSC performance capacity alongside vertical jump force-time asymmetries in female ACLR alpine skiers

Lower Limb Asymmetry in Mechanical Muscle Function: A Comparison Between Ski Racers With and Without ACL Reconstruction

Due to a high incidence of anterior cruciate ligament (ACL) re-injury in alpine ski racers, the aim was to assess functional asymmetry in the countermovement jump (CMJ), squat jump (SJ) and leg muscle mass in elite ski racers with and without anterior cruciate ligament reconstruction (ACL-R). Elite alpine skiers with ACL-R (n=9; 26.2±11.8 months post-op) and uninjured skiers (n=9) participated in neuromuscular screening. Vertical ground reaction force during the CMJ and SJ was assessed using dual force plate methodology to obtain phase-specific bilateral asymmetry indices (AI) for kinetic impulse (CMJ and SJ phase-specific kinetic impulse AI). Dual X-Ray absorptiometry (DXA) scanning was used to assess asymmetry in lower body muscle mass. Compared to controls, ACL-R skiers had increased AI in muscle mass (P<0.001), kinetic impulse AI in the CMJ concentric phase (P<0.05) and the final phase of the SJ (P<0.05). Positive associations were observed between muscle mass and AI in the CMJ concentric phase (r=0.57, P<0.01) as well as in the late SJ phase (r=0.66, P<0.01). Future research is required to assess the role of the CMJ and SJ phase-specific kinetic impulse asymmetry index as a part of a multi-faceted approach for improving outcome following ACL-R in elite ski racers.Ye

Physical exercise at the workplace prevents deterioration of work ability among healthcare workers:cluster randomized controlled trial

BACKGROUND: Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. METHODS: Two hundred female healthcare workers (Age: 42.0, BMI: 24.1, work ability index [WAI]: 43.1) from 18 departments at three Danish hospitals participated (Copenhagen, Denmark, Aug 2013—Jan 2014). Participants were randomly allocated at the cluster level to 10 weeks of: 1) workplace physical exercise (WORK) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. RESULTS: Significant group by time interaction was observed for WAI (p < 0.05). WAI at follow-up was 1.1 (0.3 to 1.8) higher in WORK compared with HOME corresponding to a small effect size (Cohens’d = 0.24). Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in HOME. Of the seven items of WAI, item 2 (work ability in relation to the demands of the job) and item 5 (sickness absence during the past year) were improved in WORK compared with HOME (P < 0.05). CONCLUSIONS: Performing physical exercise together with colleagues at the workplace prevents deterioration of work ability among female healthcare workers. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT01921764. Registered 10 August 2013

Associations between biopsychosocial factors and chronic upper limb pain among slaughterhouse workers:cross sectional study

BACKGROUND: Knowledge of factors associated with chronic pain is necessary for preventive strategies. The present study investigates biopsychosocial differences, with specific focus on rate of force development (RFD) and work ability, between workers with and without chronic upper limb pain. METHODS: Eighty-two male slaughterhouse workers, 49 with chronic upper limb pain and 33 pain-free controls participated in the study. Maximal muscle strength, RFD, and muscle activity was determined from fast and forceful maximal voluntary contractions for the shoulder and hand. Participants filled out a questionnaire on work ability (work ability index), work disability (Work module of DASH questionnaire), fear avoidance, and self-rated health. Additionally, pressure pain threshold (PPT) was measured in muscles of the arm, shoulder and lower leg. RESULTS: Muscle strength and RFD (determined within time intervals of 30, 50, 100, and 200 ms relative to onset of contraction) was 28 % and 58–78 % lower, respectively, in workers with chronic pain compared with pain-free controls, and paralleled by reduced muscle activity (all p < 0.001). Workers with chronic pain had lower PPT of the arm, shoulder and lower leg (p < 0.01), and reported impaired work ability index score and general health along with higher work disability and fear avoidance compared with controls (all p < 0.0001). No differences were observed between the groups in regard to age, BMI, physical activity level, job position and duration of slaughterhouse work (all p > 0.4). CONCLUSIONS: Chronic upper limb pain was paralleled by reduced neuromuscular function of the shoulder and hand along with impaired work ability, work disability and general health. Future studies on chronic pain management at the workplace should carefully consider the biopsychosocial nature of pain when designing and implementing preventive strategies

Design Optimization of a 5 MW Floating Offshore Vertical-axis Wind Turbine

This paper outlines results of a proposed layout of a light 2-bladed rotor, with a driving torque constraint matching the generator design, and shows details of the pultruded blade – and rotor geometry. In comparison with the 1st baseline design of a 5 MW VAWT concept this present development provides during standstill and operation significant less mass with a comparable level of loading strain in the blades and in the junctions between blade and tower. Optimized blade profile having a low weight and high stiffness is obtained according to the design evaluations based on the standstill calculations in ANSYS software. The selected profiles are used in the aero dynamic simulation. Furthermore the simulation code will be demonstrated to show the fully development model, integrating the simulation of turbulent wind inflow, actuator cylinder flow model, power controls, hydraulic floater - and mooring line systems implementation

Nurses’ and Doctors’ Experiences of Transferring Adolescents or Young Adults With Long-Term Health Conditions From Pediatric to Adult Care: A Metasynthesis

The transfer of adolescents and young adults (AYA) with long-term health conditions from pediatric to adult care is a multidisciplinary enterprise where nurses and doctors play an important role. This review aimed to identify and synthesize evidence from qualitative primary reports on how nurses and doctors experience the transfer of AYA aged 13 to 24 years with long-term health conditions to an adult hospital setting. We systematically searched seven electronic databases for reports published between January 2005 and November 2021 and reporting nurses’ and doctors’ experiences. We meta-summarized data from 13 reports derived from 11 studies published worldwide. Using qualitative content analysis, we metasynthesized nurses’ and doctors’ experiences into the theme “being boosters.” Boosting AYA’s transfer was characterized by supporting AYA’s and their parents’ changing roles, smoothening AYA’s transition from pediatric to adult care, and handling AYA’s encounters with a different care culture.publishedVersio

Parents’ experiences of transitioning to home with a very-low-birthweight infant: A meta-ethnography

Medical-technological advances and neurodevelopmental care have improved the survival of extremely- and very-low-birthweight infants born before 32 weeks’ gestation. After months in neonatal care, the infants are discharged, and parents exited but full of anxiety. This review is designed as a meta-ethnography, addressing parents’ discharge experiences to comprehend the synthesised research, which includes 12 eligible studies. From the analysis, we constructed three themes: ‘approaching discharge with both uncertainty and confidence’; ‘discharge as a longed-for though disordering turning point’; and ‘facing joys, worries and multiple challenges when at home’. The overarching interpretation was ‘discharge as double-edged sword’. We conclude that bringing home very-low-birthweight infants is a joyful event, yet parents also experience discharge as never- endingly worrying, as a time filled with challenges to which parents must adapt and as necessitating contin- uous support from knowledgeable providers.publishedVersio