Project description:Background and aimsSedentary behavior and physical inactivity are associated with musculoskeletal disorders (MSD). Muscle and mobility enhancing training is recommended to promote musculoskeletal fitness and prevent MSD. A functional fitness program emphasizing the importance of musculoskeletal fitness is provided by CrossFit®. However, data from long-term CrossFit® interventions assessing measures of musculoskeletal fitness in sedentary and inactive individuals does not exist.MethodsThis prospective, controlled study investigates the effects of 6 months CrossFit® training (2×60 min/week) in inactive adults (in terms of <2 muscle or mobility enhancing training sessions per week) with predominantly sitting or standing occupations. 91 participants were initially assessed, 2 were excluded, 55 self-selected for intervention (IG), and 34 for the control group (CG). Primary endpoint was a change in mobility (Functional Movement Screen score). Secondary endpoints were changed in strength (maximum isometric strength in kg; Dr. Wolff BackCheck®), and well-being (WHO-5 score). Key exploratory endpoints were changes in back-issue measures (pain intensity, limitation, and frequency).Results39 participants of IG and 31 of CG completed the evaluation after 6 months. The IG improved significantly more (p < 0.001) compared with the CG in the FMS (η² = 0.58), trunk extension (η² = 0.46), trunk flexion (η² = 0.47), trunk lateral flexion left (η² = 0.41), trunk lateral flexion right (η² = 0.42), upper body push (η² = 0.4), upper body pull (η² = 0.25), hip extension left (η² = 0.18), and hip extension right (η² = 0.4). Change of WHO-5 scores did not significantly differ between groups (p = 0.55; η² = 0.01). Exploratory analysis of back-issue data showed a higher decrease for pain intensity, limitation, and frequency in the IG compared with the CG.ConclusionThis study proves for the first time within the scope of a prospective, controlled study the broad benefits of CrossFit® in inactive adults doing predominantly sedentary work.
Project description:BackgroundTo understand the potential influencing factors on the effectiveness of workplace health promotion interventions and examine whether workplace health culture and physical environment can mediate the relationship between workplace health promotion and intervention effectiveness.MethodsA total of 719 participants from 10 Chinese government agencies were recruited for a prospective self-controlled trial. Questionnaires, qualitative interviews, and direct observation were used for the baseline evaluation, process evaluation, and effectiveness evaluation. Based on the results of the need assessment and risk assessment at each workplace, a two-year comprehensive health intervention was conducted by each workplace. Health outcomes including self-rated health (SRH) and mental health were measured at baseline and 24 months. Health culture was measured at 24 months. Physical environment and intervention implementation were measured at 12 months and 24 months.ResultsCompared with the baseline, the means of SRH and mental health increased significantly by 0.302 and 2.698, respectively. The SRH scores were different before and after intervention; furthermore, the differences varied by workplace. Health culture mediated the relationship between intervention implementation and intervention effectiveness, including SRH and mental health improvement, but physical environment did not. Physical environment quality was significantly negatively correlated with SRH improvement and mental health improvement. Under the relatively high-quality interventions with scores higher than 4.047 or 4.151 (out of 5), better health culture may led to greater SRH and mental health improvements.ConclusionsHealth culture may mediate the relationship between intervention implementation and intervention effectiveness, whereas physical environment does not seem to mediate this relationship. Under relatively high-quality interventions, a better health culture may lead to more positive improvements in SRH and mental health. Future studies will need to examine the physical environment as a moderating effect rather than mediating effect.Trial registrationThis study was retrospectively registered in Chinese Clinical Trial Registry.Trial registration numberChiCTR-OOC-16010059 . Date of registration: Dec 1, 2016.
Project description:PurposeThis study aimed to explore how patients treated for endometrial cancer (EC) with robotic surgery are affected in symptoms of anxiety and depression and HRQoL in the long term.MethodsWomen scheduled for primary robotic surgery for EC were included (n = 64), in this single-center study. Socioeconomic variables were obtained at baseline. The European Organization for Research and Treatment of Cancers Quality of Life Questionnaire Core 30 (QLQ-C30), its module for EC (EN24), the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire Depression Scale (PHQ-9) were followed prospectively from baseline to 2 weeks, 3 months and 1 year postoperatively.ResultsThe number of patients scoring above the clinical threshold for anxiety decreased from 17 (27.0%) at baseline to 4 (7.0%) at 2 weeks (p = 0.012). Depressive symptoms were reported in 20% of patients at baseline and did not change significantly during the one-year follow-up (p = 0.58). A significant decrease in Global health status was seen at 2 weeks (from 69.8 to 62.7; p = 0.048), with return to baseline levels after 3 months (68.5; p = 0.32) and stable at 1 year. Unemployment, low income, and adjuvant therapy correlated with lower Global health status at 3 months.ConclusionThe significant proportion of patients with anxiety symptoms preoperatively reduced prompt after surgery, while the proportion with depression remained constant, indicating that the primary treatment has no long-term negative effect on patients' mental health. At 3 months, there is no obvious remaining negative impact on patients' HRQoL, and these results are consistent after 1 year.
Project description:PurposeEmergency airway management can be associated with a range of complications including long-term neurologic injury and death. We studied the first-pass success rate with emergency airway management in a tertiary care trauma centre. Secondary outcomes were to identify factors associated with first-pass success and factors associated with adverse events peri-intubation.MethodsWe performed a single-centre, prospective, observational study of patients ≥ 17 yr old who were intubated in the emergency department (ED), surgical intensive care unit (SICU), medical intensive care unit (MICU), and inpatient wards at our institution. Ethics approval was obtained from the local research ethics board.ResultsIn a seven-month period, there were 416 emergency intubations and a first-pass success rate of 73.1%. The first-pass success rates were 57.5% on the ward, 66.1% in the intensive care units (ICUs) and 84.3% in the ED. Equipment also varied by location; videolaryngoscopy use was 65.1% in the ED and only 10.6% on wards. A multivariate regression model using the least absolute shrinkage and selection algorithm (LASSO) showed that the odds ratios for factors associated with two or more intubation attempts were location (wards, 1.23; MICU, 1.24; SICU, 1.19; reference group, ED), physiologic instability (1.19), an anatomically difficult airway (1.05), hypoxemia (1.98), lack of neuromuscular blocker use (2.28), and intubator inexperience (1.41).ConclusionsFirst-pass success rates varied widely between locations within the hospital and were less than those published from similar institutions, except for the ED. We are revamping ICU protocols to improve the first-pass success rate.
Project description:IntroductionThe worldwide rising levels of physical inactivity especially in the United Arab Emirates (UAE) and the Eastern Mediterranean region are alarming. The UAE reports one of the highest rates of non-communicable disease mortality and insufficient physical activity (PA) is a major underlying cause. Therefore, action is required to reduce physical inactivity using evidence-based strategies. This study aimed to evaluate the efficacy of a worksite exercise intervention on cardiometabolic health in the UAE.Methods and analysisThis is a protocol for a pragmatic parallel randomised controlled trial with a 1:1 allocation ratio to the intervention group and delayed intervention group. A total of 150 participants will be recruited from a semigovernment telecommunications company in Dubai (UAE) after meeting the eligibility criteria. The intervention group will receive 2 hours of exercise per week during working hours for 12 weeks (maximum 1 hour/day). The intervention group will be assigned to attend personal trainer sessions in the workplace gym throughout the intervention period. After the intervention is completed, the delayed intervention group will also receive 2 hours of exercise time per week from working hours for 4 weeks. The main outcome measure is the change in the cardiometabolic risk components, that is, systolic or diastolic blood pressure, waist circumference, glycated haemoglobin, fasting plasma glucose, low-density lipoprotein cholesterol from baseline to the end of the intervention. The secondary outcome is to examine whether the workplace exercise intervention improves PA levels 4 weeks postintervention.Ethics and disseminationThe study has been approved by the Dubai Scientific Research Ethics Committee (DSREC-SR-08/2019_02). The results will be disseminated as follows: at various national and international scientific conferences; as part of a PhD thesis in Public Health at the College of Medicine and Health Sciences, UAE University; and in a manuscript submitted to a peer-reviewed journal.Trial registration numberNCT04403789.
Project description:BackgroundWeight management constitutes a substantial problem particularly among groups of low socio-economic status. Interventions at work places may be a solution, but high quality worksite interventions documenting prolonged weight loss are lacking. This paper presents results of an intervention aimed to achieve a 12 months weight loss among overweight health care workers.MethodsNinety-eight overweight female health care workers were randomized into an intervention or a reference group. The intervention consisted of diet, physical exercise and cognitive behavioral training during working hours 1 hour/week. The reference group was offered monthly oral presentations. Several anthropometric measures, blood pressure, cardiorespiratory fitness, maximal muscle strength, and musculoskeletal pain were measured before and after the 12-months intervention period. Data were analyzed by intention-to-treat analysis.ResultsThe intervention group significantly reduced body weight by 6 kg (p < 0.001), BMI by 2.2 (p < 0.001) and body fat percentage by 2.8 (p < 0.001). There were no statistical reductions in the control group, resulting in significant differences between the two groups over time.ConclusionsThe intervention generated substantial reductions in body weight, BMI and body fat percentage among overweight female health care workers over 12 months. The positive results support the workplace as an efficient arena for weight loss among overweight females.Trial registrationNCT01015716.
Project description:BackgroundIn the present study the effect of a workplace-oriented intervention for persons on long-term sick leave for clinical burnout, aimed at facilitating return to work (RTW) by job-person match through patient-supervisor communication, was evaluated. We hypothesised that the intervention group would show a more successful RTW than a control group.MethodsIn a prospective controlled study, subjects were identified by the regional social insurance office 2-6 months after the first day on sick leave. The intervention group (n = 74) was compared to a control group who had declined participation, being matched by length of sick leave (n = 74). The RTW was followed up, using sick-listing register data, until 1.5 years after the time of intervention.ResultsThere was a linear increase of RTW in the intervention group during the 1.5-year follow-up period, and 89% of subjects had returned to work to some extent at the end of the follow-up period. The increase in RTW in the control group came to a halt after six months, and only 73% had returned to work to some extent at the end of the 1.5-year follow-up.ConclusionsWe conclude that the present study demonstrated an improvement of long-term RTW after a workplace-oriented intervention for patients on long-term sick leave due to burnout.Trial registrationCurrent Controlled Trials NCT01039168.
Project description:Genome wide DNA methylation profiling of healthy obese individuals during a one-year weight loss intervention. The Illumina Infinium 450k Human DNA methylation Beadchip was used to obtain DNA methylation profiles across approximately 485,000 CpGs. Adipose tissue biopsies were collected at three time points, baseline (T0), Fifth month (T1) and Twelfth month (T2).