Musculoskeletal symptoms and computer use among Finnish adolescents - pain intensity and inconvenience to everyday life : a cross-sectional study

Background: Musculoskeletal symptoms among adolescents are related to the time spent using a computer, but little is known about the seriousness of the symptoms or how much they affect everyday life. The purpose of the present study was to examine the intensity of musculoskeletal pain and level of inconvenience to everyday life, in relation to time spent using a computer. Methods: In a survey, 436 school children (12 to 13 and 15 to 16 years of age), answered a questionnaire on musculoskeletal and computer-associated musculoskeletal symptoms in neck-shoulder, low back, head, eyes, hands, and fingers or wrists. Pain intensity (computer-associated symptoms) and inconvenience to everyday life (musculoskeletal symptoms) were measured using a visual analogue scale. Based on the frequency and intensity, three categories were formed to classify pain at each anatomic site: none, mild, and moderate/severe. The association with time spent using the computer was analyzed by multinomial logistic regression. Results: Moderate/severe pain intensity was most often reported in the neck-shoulders (21%); head (20%); and eyes (14%); and moderate/severe inconvenience to everyday life was most often reported due to head (29%), neck-shoulders (21%), and low back (16%) pain. Compared with those using the computer less than 3.6 hours/week, computer use of >= 14 hours/week, was associated with moderate/severe increase in computer-associated musculoskeletal pain at all anatomic sites (odds ratio [OR] = 2.9-4.4), and moderate/severe inconvenience to everyday life due to low back (OR = 2.5) and head (OR = 2.0) pain. Conclusions: Musculoskeletal symptoms causing moderate/severe pain and inconvenience to everyday life are common among adolescent computer users. Daily computer use of 2 hours or more increases the risk for pain at most anatomic sites.Peer reviewe

Strategies and barriers to achieving the goal of Finland's tobacco endgame.

ObjectivesFinland boldly legislated the end of tobacco use in its 2010 Tobacco Act, and subsequently expanded the goal in 2016 to eradicate other nicotine-containing products. This study explored stakeholders' perceptions about the strengths, barriers, solutions and rationale for Finland's comprehensive but conventional strategy to achieve its nicotine-free goal.DesignStudy participants were selected based on expertise in policy or practice of tobacco control (n=32). Semi-structured interviews, conducted in 2017 and 2018, covered topics ranging from consensus among stakeholders to Finland's ranking on the 2016 Tobacco Control Scale. The framework method was chosen for analysing interview transcripts.ResultsA perceived strength of Tobacco-Free Finland 2030 was the consensus and cooperation among members of the tobacco control community. The objective of becoming a nicotine- versus smoke-free society had almost unanimous support, challenged by a small minority who argued for greater discussion of harm reduction approaches. The need for maintaining legitimacy and historical successes in tobacco control were reasons for using a conventional strategy. Barriers to achieving the endgame goal included insufficient funding and over-reliance on non-governmental organisations, political/legal constraints, impact of institutional practices on tobacco disparities, ambivalence about the role of mass media and lack of prioritising smoking cessation.ConclusionsStakeholders' broad confidence in reaching the goal of Finland's tobacco endgame suggests that future policy initiatives will reflect the current, conventional strategy. If the Finnish government chooses to continue this approach, then it should designate separate funds for Tobacco-Free Finland 2030 and implement structural changes that will facilitate tobacco control initiatives