adults were based on university students and/or self-selected participants. In summary, intense or frequent mobile phone use was seen to be associated with a broad spectrum of mental health outcomes, e.g. depressive symptoms and sleep problems. Mobile phone use at bedtime was associated with shorter sleep duration and lower sleep quality. 'Problematic use', i.e., mobile phone use connected to behavioural addiction or pathological usage, was associated with several negative outcomes such as depression, anxiety, and sleep problems. Discussion Research studies show associations between mobile phone use and mental health outcomes. However, there is need for more studies of good quality; with longitudinal design, objective measurements, and well-defined study populations, in order to draw valid conclusions about possible causal associations between mobile phone use and mental health symptoms.
Evaluation of interventions to reduce occupational injuries in the construction industry are relatively scarce. Various interventions to prevent occupational injuries have been proposed and studied. In a Cochrane review we systematically summarise the most current scientific evidence on the effectiveness of interventions to prevent injuries associated with construction work. Most of these studies are analysed with an interrupted time series design, which are characterised by a higher risk of bias.We use the GRADE (Grades of Recommendations, Assessment, Development and Evaluation) approach that systematically represents the factors important in interpretating evidence and results in a current update of our review. While the evidence can be different for each outcome, GRADE considers the evidence for each outcome and takes into account the magnitude of effect and ensures the process is systematic and transparent.Rating of the evidence was done as follows: with RCTs we started at high quality and with observational studies we started at low quality. Then we downgraded if one of the following criteria were met: study limitations, inconsistency, indirectness, imprecision and publication bias. We upgraded observational studies if there have been dose-response, large effect size or an opposite effect of confounding. We constructed tables for every comparison for our interventions and our two primary outcomes fatal and non-fatal injuries because these were our inclusion criteria for the studies.Applying GRADE and the difference with strength of association will be discussed based on the above mentioned update of our review. Also the differences in clarity of the conclusions with and without GRADE will be discussed.
the overall construction management processes overseen by a primary contractor. A new study is underway that integrates ergonomic training, planning, and oversight within the primary contractor's safety programs, and encourages planning to reduce ergonomic hazards during the preconstruction phase.
IntroductionTo examine the association between work-related risk factors and clinically assessed specific soft tissue shoulder disorders like rotator cuff syndrome – including tendinitis of the supraspinatus, infraspinatus and/or non-traumatic tears and ruptures –, bicipital tendinitis, calcific tendinitis, impingement and bursitis.MethodsMedline and Embase were searched from 2009 until 24 March 2016 and references were added of a systematic review on this topic describing studies published before 2009. Case-control and cohort studies were included if the soft tissue shoulder disorder was clinically assessed. These shoulder disorders were grouped into subacromial pain syndrome, abbreviated to SAPS, and defined as all non-traumatic, usually unilateral, shoulder complaints that cause pain, are localised around the acromion, and often worsen during or subsequent lifting of the arm. Meta-analyses and GRADE were performed to assess evidence and quality for the studies on work-related risk factors.ResultIn total 16 300 patients with SAPS from a population of 2,413,722 workers from Denmark, Finland, France, Germany and Poland were included in the meta-analysis. Moderate evidence for associations were found for arm-hand elevation (OR=1.9, 95% CI: 1.47 to 2.47) and shoulder load (OR=2.0, 95% CI: 1.90 to 2.10). Low to very low-quality evidence was found for hand-force exertion, hand-arm vibration and psychosocial risk factors.DiscussionArm-hand elevation, hand-force exertion and hand-arm vibration during work, increase the incidence of SAPS. Especially preventive measures to reduce arm-elevation and shoulder load, the latter involving combined physical exposures, e.g. hand-force exertion and arm-elevation, are recommended to prevent these work-related shoulder disorders. Presumably psychosocial factors play an intermediate role, and therefore, should also be targeted in occupational preventive actions.
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