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BackgroundLow back pain (LBP) is common in the population and multifactorial in nature, often involving negative consequences. Reassuring information to improve coping is recommended for reducing the negative consequences of LBP. Adding a simple non-threatening explanation for the pain (temporary muscular dysfunction) has been successful at altering beliefs and behavior when delivered with other intervention elements. This study investigates the isolated effect of this specific information on future occupational behavior outcomes when delivered to the workforce.DesignA cluster-randomized controlled trial.MethodsPublically employed workers (n = 505) from 11 Danish municipality centers were randomized at center-level (cluster) to either intervention (two 1-hour group-based talks at the workplace) or control. The talks provided reassuring information together with a simple non-threatening explanation for LBP—the ‘functional-disturbance’-model. Data collections took place monthly over a 1-year period using text message tracking (SMS). Primary outcomes were self-reported days of cutting down usual activities and work participation. Secondary outcomes were self-reported back beliefs, work ability, number of healthcare visits, bothersomeness, restricted activity, use of pain medication, and sadness/depression.ResultsThere was no between-group difference in the development of LBP during follow-up. Cumulative logistic regression analyses showed no between-group difference on days of cutting down activities, but increased odds for more days of work participation in the intervention group (OR = 1.83 95% CI: 1.08–3.12). Furthermore, the intervention group was more likely to report: higher work ability, reduced visits to healthcare professionals, lower bothersomeness, lower levels of sadness/depression, and positive back beliefs.ConclusionReassuring information involving a simple non-threatening explanation for LBP significantly increased the odds for days of work participation and higher work ability among workers who went on to experience LBP during the 12-month follow-up. Our results confirm the potential for public-health education for LBP, and add to the discussion of simple versus multidisciplinary interventions.

Background Renal transplant recipients (RTRs) have increased risk of human papillomavirus (HPV)-related cancers, including anal cancer. We investigated the prevalence of anal high-grade intraepithelial lesions (HSIL) in RTRs compared with immunocompetent controls and risk factors for anal HSIL in RTRs. Methods We included 247 RTRs and 248 controls in this cross-sectional study. We obtained anal samples for HPV testing with INNO-LiPA® and performed high-resolution anoscopy on all participants. The participants completed a questionnaire on lifestyle and sexual habits. We used logistic regression to estimate odds ratios (ORs) of histologically confirmed anal HSIL in RTRs versus controls and risk factors for anal HSIL in RTRs, stratified by sex and anal high-risk (hr) HPV status, adjusting for age, smoking, lifetime sexual partners, and receptive anal sex. Results RTRs had higher anal HSIL prevalence than controls, both among men (6.5% vs 0.8%, ORadjusted=11.21, 95% CI: 1.46–291.17) and women (15.4% vs 4.0%, ORadjusted=6.41, 95% CI: 2.14–24.10). Among those with anal hrHPV, RTRs had higher anal HSIL prevalence than controls (33.8% vs 9.5%, ORadjusted=6.06, 95% CI: 2.16–20.27). Having had receptive anal sex (ORadjusted=6.23, 95% CI, 2.23–19.08) or genital warts (ORadjusted=4.21, 95% CI: 1.53–11.48) were risk factors for anal HSIL in RTRs. All HSIL cases occurred in individuals with anal hrHPV. Conclusion RTRs had increased risk of anal HSIL compared with immunocompetent controls, with particularly high prevalence in female RTRs. Receptive anal sex, previous genital warts and anal hrHPV infection were risk factors for anal HSIL in RTRs. Screening for anal HSIL in RTRs should be considered.

Offering human papillomavirus-based self-sampling to nonparticipants in routine cervical cancer screening can increase screening participation. However, little is known about characteristics of women who accept self-sampling. In this population-based study, we investigated determinants for participation in self-sampling among Danish nonattenders to routine cervical cancer screening. During 2014 to 2015, a random sample of screening nonparticipants ages 27 to 65 years living in the Capital Region of Denmark were invited for self-sampling. Of 21,314 eligible women, 4,743 participated in self-sampling. Information on sociodemographic characteristics and mental and physical health of all the women was obtained from nationwide registries, and 3,707 women completed a questionnaire on lifestyle, sexual behavior, and reasons for nonparticipation in routine screening. We used logistic regression to estimate ORs for participation in self-sampling, crude, and adjusted for sociodemographic characteristics. Basic education [OR = 0.79; 95% confidence interval (CI), 0.72-0.88], low income (OR = 0.66; 95% CI, 0.59-0.73), origin from a nonwestern country (OR = 0.43; 95% CI, 0.38-0.48), and being unmarried (OR = 0.66; 95% CI, 0.61-0.72) were associated with lower self-sampling participation. Long-term unscreened women (OR = 0.49; 95% CI, 0.45-0.53), women with prior schizophrenia or other psychoses (OR = 0.62; 95% CI, 0.48-0.80), women with poor self-perceived health (OR = 0.42; 95% CI, 0.25-0.69), and women who perceived screening as unnecessary (OR = 0.54; 95% CI, 0.37-0.80) or irrelevant (OR = 0.81; 95% CI, 0.78-0.96) were less likely to self-sample. Certain population groups, including women with low socioeconomic position or of nonwestern origin, were less likely to participate in self-sampling. Targeted approaches may be needed to increase screening participation in these groups.