BackgroundHealth workers are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multi-faceted intervention in two public tertiary hospitals, encompassing three levels of prevention and health promotion to prevent and manage MSP.MethodsA two-armed cluster randomized controlled trial, with a late intervention control group was performed. Clusters were independent hospital units, and participants were the nursing staff. The intervention comprised three components: participatory ergonomics, case management, and health promotion. The control group received usual occupational health care. The intervention lasted one year and data were collected at baseline, 6 and 12 months follow-up. Primary outcomes were self-perceived MSP and its associated sickness absence. The process evaluation included recruitment, context, reach, dose administered and received, fidelity, satisfaction, implementation strategy, and discussion groups of experts and participants.ResultsEight clusters, including 445 participants, were randomized. In the intervention group a 20% statistically significant reduction of neck, shoulders and upper back pain compared to the control group (OR=0.37; 95% CI=0.14–0.96) was observed at 12 months follow-up. We found no significant differences in incidence and duration of sickness absence. Organizational culture (secondary outcome) improved significantly in the intervention group in the domains of ‘formal safety audits’, ‘availability of information for safety at work’, and ‘involvement of workers in decisions that affect their safety and health’ compared to the control group. The intervention was implemented with 96.6% fidelity, and participants’ adherence was 75.5%. Participant’s satisfaction was 9.1/10.ConclusionsThis intervention showed effectiveness to reduce MSP and improve organizational culture, through to an integral management of MSP. Although our results are modest, strategies should focus on multi-faceted interventions, and occupational health services might be excellent opportunity for.
Knudsen, K., van Zon, S., Tsurykau, A., Kocourková, J., Hodkoavá, E., Huereca, A. & Malíček, J. 2023. Sarcogyne (Acarosporaceae) on calcareous rock in Europe and North America – Herzogia 36: 52–71.Sarcogyne pruinosa and S. regularis are revised and lectotypes selected. Sarcogyne pruinosa is recognized as oldest name for the species and S. regularis as a synonym. The description of the species is revised. Sarcogyne pruinosa does not occur in North America. Two new species are described, Sarcogyne nimisii from Italy and Sarcogyne belarusensis from Belarus, Germany and Italy. Sarcogyne platycarpoides is lectotypified and S. melaniza is recognized as its synonym. New records are reported of S. distinguenda and S. nivea from the Czech Republic and Italy and S. fallax from the Czech Republic. A key is supplied for 14 species of Sarcogyne on calcareous rock in Europe.
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ObjectiveThis study investigated the association between changing working conditions and exit from paid employment during the following year among older workers with a chronic disease in the Netherlands.MethodFour annual waves from the Study on Transitions in Employment, Ability and Motivation (STREAM; 2010–2013) provided information on working conditions and demographics for 2838 older workers with a chronic disease, aged 45–64 years. The analytical sample consisted of 5491 responses from 2838 workers. Five types of working conditions were investigated; physical workload, psychological job demands, job autonomy, emotional job demands and social support. Discrete-time survival models were used to estimate the associations of change in working conditions in a particular year on the probability of exiting paid work for persons with a chronic disease in the following year.ResultsOf the 2838 workers, a small majority was male (52%), most workers had an intermediate level of education (39.7%), and the mean age was 53.7 years (SD 5.50). Results showed that working conditions substantially changed (i.e. difference of one standard deviation) between two waves. Social support and emotional job demands had the highest amounts of substantial changes (17% and 19%), while physical demands remained relatively stable (6% substantial change). After the first two waves, about 12% of workers with a chronic illness left paid employment. Results of discrete-time survival models are expected to be available in 2019 (by the time of the EPICOH conference).ConclusionEnsuring that working conditions can be adapted to the needs of older workers who have a chronic disease may help to extend working life.
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