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INTRODUCTION: People with poor Health Literacy (HL) find it difficult to understand medical information in their daily lives, participate in health-related decision making and comply with medical instructions. The physical effects of ageing on the musculoskeletal system have a direct impact on skills related to the management of health problems. Many older adults have limited HL, which impacts their ability to fully engage in their care and their health status. The aim of this study is to conduct a systematic review of the published research regarding the prevalence of low HL and its impact on health outcomes of older adults with musculoskeletal problems. METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement, this review examined all peer-reviewed studies published in English, with specific pre-selected eligibility criteria. RESULTS: The combined searches yielded 1617 records of which 19 articles were eligible for inclusion. The percentage of low HL varied across the studies of this review, ranging from 14% to 67%. In most studies, however, patients with limited HL were about 1/3 of the participants. Patients of lower educational level, male gender, older age, lower income, unemployment and different country of origin had lower HL level. Low HL was also associated with worse health outcomes, especially adherence to treatment, pain, functionality and health status. DISCUSSION: It is of major importance to conduct educational interventions aimed at enhancing HL in this patient group, as these will contribute to the empowerment and the promotion of appropriate health behaviors of these patients.

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BACKGROUND: In recent years, the effectiveness and cost-effectiveness of digital health services for people with musculoskeletal conditions have increasingly been studied and show potential. Despite the potential of digital health services, their use in primary care is lagging. A thorough implementation is needed, including the development of implementation strategies that potentially improve the use of digital health services in primary care. The first step in designing implementation strategies that fit the local context is to gain insight into determinants that influence implementation for patients and health care professionals. Until now, no systematic overview has existed of barriers and facilitators influencing the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. OBJECTIVE: This systematic literature review aims to identify barriers and facilitators to the implementation of digital health services for people with musculoskeletal conditions in the primary health care setting. METHODS: PubMed, Embase, and CINAHL were searched for eligible qualitative and mixed methods studies up to March 2024. Methodological quality of the qualitative component of the included studies was assessed with the Mixed Methods Appraisal Tool. A framework synthesis of barriers and facilitators to implementation was conducted using the Consolidated Framework for Implementation Research (CFIR). All identified CFIR constructs were given a reliability rating (high, medium, or low) to assess the consistency of reporting across each construct. RESULTS: Overall, 35 studies were included in the qualitative synthesis. Methodological quality was high in 34 studies and medium in 1 study. Barriers (-) of and facilitators (+) to implementation were identified in all 5 CFIR domains: "digital health characteristics" (ie, commercial neutral [+], privacy and safety [-], specificity [+], and good usability [+]), "outer setting" (ie, acceptance by stakeholders [+], lack of health care guidelines [-], and external financial incentives [-]), "inner setting" (ie, change of treatment routines [+ and -], information incongruence (-), and support from colleagues [+]), "characteristics of the healthcare professionals" (ie, health care professionals' acceptance [+ and -] and job satisfaction [+ and -]), and the "implementation process" (involvement [+] and justification and delegation [-]). All identified constructs and subconstructs of the CFIR had a high reliability rating. Some identified determinants that influence implementation may be facilitators in certain cases, whereas in others, they may be barriers. CONCLUSIONS: Barriers and facilitators were identified across all 5 CFIR domains, suggesting that the implementation process can be complex and requires implementation strategies across all CFIR domains. Stakeholders, including digital health intervention developers, health care professionals, health care organizations, health policy makers, health care funders, and researchers, can consider the identified barriers and facilitators to design tailored implementation strategies after prioritization has been carried out in their local context.

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OBJECTIVE: To determine the association between anthropometric measurements of chairs and biomechanical variables leading to musculoskeletal problems in students at different government universities in Multan. METHODS: The cross-sectional study was done on 383 students at different government universities in Multan, Pakistan. There were 23 anthropometric measurements like shoulder height (SH), shoulder breadth (SB), knee height (KH), popliteal height (PH), elbow height sitting (EHS), elbow-fingertip length (EFL), abdominal depth (ABD), buttock-popliteal length (BPL), thigh thickness (TT), forearm width (FW), hip angle (HA), knee angle (KA), cervical flexion (CF), cervical extension (CE), cervical lateral flexion (CLF), cervical rotation (CR), thoracic flexion (TF), thoracic extension (TE), lumber flexion (LF), lumber extension (LE), lumber lateral flexion (LLF), and lumber rotation (LR). There were 11 dimensions of chairs: seat height (SH), seat depth (SD), seat width (SW), desk length (DL), desk width (DW), desk height (DH), backrest height (BH), backrest depth (BD), and seat pan depth (SPD) were measured in six types of commonly used chairs in different universities in Multan. This research was done to determine the fitness of chairs using combinational equations. RESULTS: There was a huge difference between most anthropometric measurements of students and chairs. The recommended measurements were SH (33.2 cm), SW (43.6 cm), SD (42 cm), DH (24.5 cm), DL (51.1 cm), DW (95 cm), BW (42.6 cm), BD (2 cm), BH (55 cm), and SPD (4 cm). CONCLUSIONS: None of the chairs used in the universities of Multan were found to be designed according to the anthropometric dimensions of students, resulting in musculoskeletal problems. It is necessary to revise the design of chairs according to the anthropometric data of students to minimize musculoskeletal problems.

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Background: To assess the effectiveness of educational intervention to reduce the weight of school bags. Material and Methods: The study design was one group pre- and posttest experimental Research design. Place and Duration of Study: Government Senior Secondary School Dhanas, Chandigarh, and Shri Guru Harkrishan Model Senior Secondary School Sector-38D, Chandigarh (A private school) between July and November 2018. Names of the schools can be avoided. Total 760 students from selected sections nursery to 10th class of school were enrolled in the study. At baseline and end line weight of children, school bags and its content were weighed using weighing scale. Length of bag strap, breath of bag, torso of children, and their shoulders size were measured by measuring tape. Bag carrying style, posture, etc., were observed by observation checklist. Interviewed children (5th to 10th class) were using Nordic musculoskeletal questionnaire for musculoskeletal system assessment. Educational intervention was provided to the children for one month to reduce weight of school bag by teaching in assembly and displaying the charts in school. (Use of softbound thin textbooks, breaking thin books in 2-3 thin softbound books, use lightweight bag, pencil box, lunch box, and water bottles. Pack bag as per timetable.). Result: The result revealed that heavy school bags were carrying 69.7% children from government school and 80.2% from private school. Children carrying heavy bags reported musculoskeletal problems 5 times higher than their counterparts. After intervention, there was significant reduction in the weight of school bags (P < 0.001 as per paired t-test). Provide the weight of the bags before and after intervention in addition to the P value. Conclusion: Children carrying heavy bags were suffering from musculoskeletal problems. Intervention helped in reducing the weight of school bag.

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Augmented reality (AR) interactions have been associated with increased biomechanical loads on the neck and shoulders. To provide a better understanding of the factors that may impact such biomechanical loads, this repeated-measures laboratory study evaluated the effects of error rates and target sizes on neck and shoulder biomechanical loads during two standardized AR tasks (omni-directional pointing and cube placing). Twenty participants performed the two AR tasks with different error rates and target sizes. During the tasks, angles, moments, and muscle activity in the neck and shoulders were measured. The results showed that the target sizes and error rates significantly affected angles, moments, and muscle activity in the neck and shoulder regions. Specifically, the presence of errors increased neck extension, shoulder flexion angles and associated moments. Muscle activity in the neck (splenius capitis) and shoulder (anterior and medial deltoids) also increased when the errors were introduced. Moreover, interacting with larger targets resulted in greater neck extension moments and shoulder abduction angles along with higher muscle activity in the splenius capitis and upper trapezius muscles. These findings indicate the importance of reducing errors and incorporating appropriate target sizes in the AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders.

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Resource recycling has become an integral part of environmental protection efforts. At present, the development of Taiwan's resource recovery and related works are quite mature. However, laborers or volunteers working in resource recycling stations may be exposed to different types of hazards during the recycling process. These hazards can be divided into biological, chemical, and musculoskeletal problems. These hazards are usually related to the work environment and work habits; therefore, a related control strategy is needed. Tzu Chi's recycling business has been running for over 30 years. In addition to leading the trend of resource recycling in Taiwan, many elderly people have also participated in Tzu Chi recycling stations as volunteers. These older volunteers may be more sensitive to exposure to hazards, and thus the focus of this review is to illustrate the possible hazards and health impacts of resource recovery work and to recommend relevant interventions to improve occupational health during resource recovery work.

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Background and Aim: pGALS (pediatric Gait Arms Legs Spine) is a useful screening tool in identifying musculoskeletal problems in children. Although musculoskeletal problems are common in children, only a small fraction of them have an underlying serious pathology. There is limited data on this subject from north India but none from south India. Our aim was to identify the prevalence of musculoskeletal problems in school going boys in the local community. Methods: We conducted a prospective cross-sectional study among school boys 7-17 years of age from September 2017 to July 2019, in Chennai. The parents or the boys were asked pGALS screening questions and this was followed by the extended pGALS examination including Beighton's scoring for hypermobility. If abnormalities in the screening tool were found, the subjects were then referred to a pediatric rheumatologist for further evaluation. Results: A total of 1543 boys were included in this study. Of these 37% of the study group were found to be hypermobile. According to our study, the prevalence of growing pains was 4.6%. Of 2 boys with suspected pathology 1 boy had enthesitis-related arthritis and another had slipped upper femoral epiphysis (SUFE). The estimated prevalence of juvenile idiopathic arthritis (JIA) was 65/100000. According to our study 12.3% of the children were obese. Conclusion: pGALS is a useful tool to screen for musculoskeletal problems in school going boys. The estimated prevalence of JIA was 65/100000. Of them, 37% of the children had hypermobility. Obese children were more likely to complain of musculoskeletal pain (P value 0.00).

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Aim: The present study was undertaken to assess the knowledge and practice of ergonomics among dental practitioners in Riyadh, Saudi Arabia. Methodology: A self-administered questionnaire was distributed among dental practitioners through Google Forms. Link of the questionnaire was sent through social media and e-mail. The questionnaire was focused on the awareness of ergonomics and practice of ergonomics during dental practice. Results: About 97.9% of participants are aware of different operating positions. About 71.7% of participants rate their operating procedure chair positions as good. 52.5% admit they feel numb fingers while working. Many questions were statistically significant according to educational qualification and type of practice (P < 0.050. Conclusion: Majority of the study population were aware of proper chair positions, correct operating procedures and were practicing four-handed dentistry, maintained proper back support while working, and even performed stretching exercises during clinical working hours.

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BACKGROUND: The nature of the work of sewing machine operators predisposes them to a wide variety of symptoms of musculoskeletal disorders and obesity. However, there is a paucity of studies on the prevalence and associated factors for symptoms of work-related musculoskeletal disorders (WMSDs) among this occupational group. OBJECTIVES: This study aimed to determine the prevalence of symptoms of WMSDs and their association with personal and occupational factors and body mass index (BMI) among sewing machine operators of Sindh province in Pakistan. METHODS: This cross-sectional study was conducted on male sewing machine operators in two major cities (i.e., Hyderabad and Nawabshah) of Sindh province in Pakistan. Obesity was determined through the BMI cutoff values for Asians. Standardized Nordic Musculoskeletal Questionnaire and Numeric Rating Scale were used. Data analysis was performed using SPSS v20. RESULTS: Of the 200 participants, 91% participants had symptoms of WMSDs in the past 12 months. Most (41.5%) participants reported pain and discomfort during the last 12 months in the lower back region. Symptoms of WMSDs in the lower back region had a significant positive association with working days/week (r = .196 p = .005). Symptoms of WMSDs in the ankle/feet region had a significant positive association with age (r = .246 p = .001) and work experience (r = .276 p = .001). CONCLUSIONS: Prevalence of symptoms of work-related musculoskeletal disorders is high among sewing machine operators of Sindh province in Pakistan, with significant associations between personal and occupational factors.

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Since the Syrian war in 2011, Syrian refugees in Lebanon have continued to experience socioeconomic deprivation, resorting many families to child labour as a form of survival. Adopting a gender-sensitive analysis, this study explores the relationship between psychosocial adversities and musculoskeletal pain among male and female Syrian refugee children in Lebanon, using data from a cross-sectional survey of working Syrian refugee children between 8 and 18 years in informal tented settlements in the Bekaa Valley of Lebanon. The majority of working children (4090) worked in agriculture (75.8%). Of the children who experienced musculoskeletal pain, 27.4% worked despite severe pain, three-quarters of the children worked under time pressure, over a third (37.4%) were physically abused at work, and the majority (95.8%) had a good relationship with their co-workers. Logistic regression models revealed a significant association between exposure to psychosocial stressors at work and musculoskeletal pain among male and female children.Practitioner summary: This study is the first to obtain direct testimony on musculoskeletal pain and psychosocial risk factors, among Syrian refugee children in Lebanon. Using a gender-sensitive analysis, the survey results demonstrated associations between exposure to psychosocial stressors and musculoskeletal pain among male/female Syrian refugee children enduring strenuous working conditions.

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AIMS: The aim of this study is to define a core outcome set (COS) to allow consistency in outcome reporting amongst studies investigating the management of orthopaedic treatment in children with spinal dysraphism (SD). METHODS: Relevant outcomes will be identified in a four-stage process from both the literature and key stakeholders (patients, their families, and clinical professionals). Previous outcomes used in clinical studies will be identified through a systematic review of the literature, and each outcome will be assigned to one of the five core areas, defined by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). Additional possible outcomes will be identified through consultation with patients affected by SD and their families. RESULTS: Outcomes identified in these stages will be included in a two-round Delphi process that will involve key stakeholders in the management of SD. A final list including the identified outcomes will then be summarized in a consensus meeting attended by representatives of the key stakeholders groups. CONCLUSION: The best approach to provision of orthopaedic care in patients with SD is yet to be decided. The reporting of different outcomes to define success among studies, often based on personal preferences and local culture, has made it difficult to compare the effect of treatments for this condition. The development of a COS for orthopaedic management in SD will enable meaningful reporting and facilitate comparisons in future clinical trials, thereby assisting complex decision-making in the clinical management of these children. Cite this article: Bone Jt Open 2022;3(1):54-60.

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Context: The precarious nature of the work in the unorganized e-waste processing sector poses a threat to workers' health by making them vulnerable to occupational injuries as well as other work-related diseases in addition to job insecurity and related issues. Aims: To systematically explore and quantify employment and working conditions along with the occupational health problems and healthcare-seeking practices of workers processing e-waste in the slums of a south Indian city. Settings and Design: Cross-sectional study conducted in the slums of a south Indian city. Methods and Material: We used a structured interview schedule among 248 randomly selected workers. Statistical Analysis Used: Descriptive statistics were utilized to summarize the results. 95% CI was calculated for select proportions. Chi-square tests were used to determine statistical significance. Results: We found a predominance of self-employment; unclear employment relationship; no paid holidays; long working hours; unequal wages; absence of work-related social security; absent workers' organization; rented units; minimal/no use of safety equipment, no concept of good ergonomic practices. The commonest occupational health concerns were injuries (17% & 41% respectively) and musculoskeletal problems (43.5%). Private/charitable clinics were the commonest source of seeking healthcare which contributed to 'irrational' practices in the form of repeated TT injections. Conclusions: Findings suggest that the precarious work in the unorganized e-waste processing sector could not only give rise to health problems but also make workers undermine the severity of their health problems. The non-responsiveness of the local public healthcare system compels them to rely on private and charitable clinics and pay for services that are otherwise freely available in UPHCs.

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The aim of this study was to identify the relationship between musculoskeletal problems and sleep quality and exposure to occupational hazards in working pregnant women. The study included a total of 142 pregnant women working in various industries. The risk of experiencing musculoskeletal system problems was found to increase with impaired sleep quality (OR interval min =1.132 max =1.303). As the amount of work-related physical damage increased, musculoskeletal complaints increased (OR interval min = 1.228 max = 1.527). Environmental hazards and psychosocial hazards seemed to increase the risk of having musculoskeletal problems (OR interval min = 1.209 max = 1.465, and OR interval min = 1.326 max = 1.547, respectively). Physical, psychosocial and workplace environmental hazards seemed to increase the risk of musculoskeletal complaints in pregnancy. It was also seen that as sleep quality decreased, so musculoskeletal complaints increased.Impact StatementWhat is already known about this subject? Occupational hazards and poor sleep quality can be associated with adverse health outcomes. Pregnant women working in different industries in Turkey may also face work-related hazards. They may also experience pregnancy-related sleep problems. In this context, there is a need to identify occupational hazards and problems related to sleep and to provide protective strategies.What do the results of this study add? The most frequent physical hazard was determined to be a simultaneous bending and rolling movement, the most frequent work environment hazard was noise exposure and the most frequent psychosocial hazard was the lack of a reward system. Physical, work environment and psychosocial hazards were observed to increase the risk of musculoskeletal problems. Moreover, the risk of having musculoskeletal problems increased as sleep quality deteriorated.What are the implications of these findings for clinical practice and/or further research? Training should be planned for working women, including the idea of conception and work-related hazards and protective strategies. It may be possible to provide arrangements related to the workplace by including employers in this training.

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BACKGROUND: Musculoskeletal disorders (MSD) are a common health problem among dentists. Dental treatment is mainly performed in a sitting position. The aim of the study was to quantify the effect of different ergonomic chairs on the sitting position. In addition, it was tested if the sitting position of experienced workers is different from a non-dental group. METHODS: A total of 59 (28 m/31f) subjects, divided into two dentist groups according to their work experience (students and dentists (9 m/11f) < 10 years, dentists (9 m/10f) ≥ 10 years) and a control group (10 m/10f) were measured. A three-dimensional back scanner captured the bare back of all subjects sitting on six dentist's chairs of different design. Initially, inter-group comparisons per chair, firstly in the habitual and secondly in the working postures, were carried out. Furthermore, inter-chair comparison was conducted for the habitual as well as for the working postures of all subjects and for each group. Finally, a comparison between the habitual sitting posture and the working posture for each respective chair (intra-chair comparison) was conducted (for all subjects and for each group). In addition, a subjective assessment of each chair was made. For the statistical analysis, non-parametric tests were conducted and the level of significance was set at 5%. RESULTS: When comparing the three subject groups, all chairs caused a more pronounced spinal kyphosis in experienced dentists. In both conditions (habitual and working postures), a symmetrical sitting position was assumed on each chair. The inter-chair comparisons showed no differences regarding the ergonomic design of the chairs. The significances found in the inter-chair comparisons were all within the measurementerror and could, therefore, be classified as clinically irrelevant. The intra-chair comparison (habitual sitting position vs. working sitting position) illustrated position-related changes in the sagittal, but not in the transverse, plane. These changes were only position-related (forward leaned working posture) and were not influenced by the ergonomic sitting design of the respective chair. There are no differences between the groups in the subjective assessment of each chair. CONCLUSIONS: Regardless of the group or the dental experience, the ergonomic design of the dentist's chair had only a marginal influence on the upper body posture in both the habitual and working sitting postures. Consequently, the focus of the dentist's chair, in order to minimize MSD, should concentrate on adopting a symmetrical sitting posture rather than on its ergonomic design.

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BACKGROUND: Workplace musculoskeletal disorders are the leading cause of morbidity and disability in the Australian workforce. Over one in five occupational therapists report workplace musculoskeletal disorders, with almost half reporting workplace musculoskeletal symptoms. In other health professions, students and novice clinicians (≤5 years practice) experience greater risk but little is known about occupational therapy students. METHODS: In this cross-sectional study, a survey including the self-reported Standardised Nordic Musculoskeletal Questionnaire was administered to occupational therapy students post work-based training. Musculoskeletal problems were defined as aches, pains, numbness or discomfort. Questions explored body sites affected, prevalence, impact on activity, need for medical assistance, demographic and workplace information. Prevalence was reported using descriptive statistics. Factors associated with workplace musculoskeletal problems over the previous 12 months and last 7 days were examined using logistic regression modelling. RESULTS: Response rate was 53% (n = 211/397). One-third of respondents (33.6%, n = 71/211) reported a workplace musculoskeletal problem over 12 months. Nearly half (47.9%, n = 34/71) of these students reported a problem over the last 7 days. Neck was the most commonly affected area reported for musculoskeletal problems over the past 12 months (24.2%, n = 51/211) and shoulder areas affected over the past 7 days (10.9%, n = 23/211). Musculoskeletal problems preventing daily activities were reported most commonly from lower back problems over 12 months (23.9%, n = 17/71) and for shoulder problems over the last 7 days (21.9%, n = 7/32). Shoulders and knees were the most common body areas requiring medical attention. Previous musculoskeletal problems and female gender were associated with reported problems over 12 months and last 7 days (p < 0.05). Non-standard joint mobility (OR = 3.82, p = 0.002) and working in psychosocially focused caseloads (including mental health or case management) (OR = 3.04, p = 0.044) were also associated with reporting musculoskeletal problems over the last 7 days. CONCLUSIONS: One in three occupational therapy students already experience workplace musculoskeletal problems impacting daily activities and requiring medical assistance prior to graduation. High prevalence of musculoskeletal problems in this study calls for educators and researchers to find sustainable strategies to address these problems, with particular consideration to the impact of previous disorders and working in psychosocially focused caseloads on musculoskeletal health.

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Spastic Cerebral Palsy (CP) is the most common form of CP, comprising of 80% of all cases. Spasticity is a type of hypertonia that clinically manifests as dynamic contractures. The dynamic contracture along with the reduced level of physical activity in a child with CP leads to secondary structural and morphological changes in spastic muscle, causing real musculotendinous shortening, known as fixed contractures. When fixed muscle contractures are not treated early, progressive musculoskeletal deformities develop. As a consequence, spastic CP from a static neurological pathology becomes a progressive orthopaedic pathology which needs to be managed surgically. Orthopaedic surgical management of CP has evolved from previous "multi-event single level" procedures to a "single event multilevel" procedures, with changes in selection and execution of treatment modalities. There is increasing evidence that multilevel surgery is an integral and essential part of therapeutic management of spastic CP, but more research is needed to ensure effectiveness of this intervention on all domains of physical disability in CP.

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The posture and positioning of pediatric dentist will greatly depend upon the type of dental chair they chose while treating children. Pediatric dentists working on a traditional adult chair for treating children frequently lean forward for close proximity to oral cavity; as a result of this poor posture, they are more prone to suffer from musculoskeletal disorders. Proper positioning of dentist during treatment will improve not only their comfort but also their career longevity. The aim of the study was to assess the comfort and need of pediatric dental chair compared with traditional adult dental chair for treatment and better management of children. STUDY DESIGN: This is a questionnaire survey for postgraduate students consisting of 14 multiple-choice questions in English format. The questionnaire was structured to know whether the pediatric dental chair is beneficial compared to traditional adult dental chair while treating children. RESULTS AND CONCLUSION: Out of 92 responded members, 99% had an opinion that a pediatric dental chair is needed for treating children. They concluded that pediatric dental chair had many advantages over traditional adult dental chair while treating children and acceptance of pediatric dental chair among postgraduates is overwhelming. HOW TO CITE THIS ARTICLE: Reddy ER, Raju SS, Merum K, et al. Postgraduates' Perspective of Pediatric Dental Chair: A Questionnaire Study. Int J Clin Pediatr Dent 2020;13(3):251-254.

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BACKGROUND: Nurses in Africa are arguably the most important frontline healthcare workers available in most healthcare facilities, performing a broad range of tasks. Such tasks are considerably presumed in the causation of workload. Nursing is listed among the highly risky professions for developing low back pain. The nursing profession is ranked within the top ten professions which have a great risk of low back pain. Hence, this review aimed to ascertain whether low back pain is a significant concern for nurses in African healthcare facilities. METHODS: A comprehensive literature search of different databases with no date limit was conducted from September to November 2018 using the PRISMA guideline. The quality of the included studies was assessed using a 12-item rating system. Subgroup and sensitivity analyses were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. RESULT: In this review, 19 studies from different African regions with a total sample size of 6110 nurses were included. All the studies were carried out between 2000 and 2018. Among these, the lowest and the highest prevalence were found to be 44.1 and 82.7% respectively. The estimation of the prevalence rate of low back pain among nurses using the random-effects model was found to be 64.07% (95% CI: 58.68-69.46; P-value < 0.0001). Heterogeneity of the reviewed studies was I2 = 94.2% and heterogeneity Chi-squared = 310.06 (d.f = 18), P-value < 0.0001. The subgroup analyses showed that the highest prevalence of LBP among nurses was from West African region with prevalence rates of 68.46% (95% CI: 54.94-81.97; P-value < 0.0001) and followed by North Africa region with prevalence rate of 67.95% (95% CI: 55.96-79.94; P-value < 0.0001). CONCLUSION: Even though the overall prevalence of the present study is lower when compared to the Western and Asian studies, it indicated that the prevalence of low back pain among nurses is substantial.

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From the start of their career, nursing students and novice nurses are at risk of developing physical health problems due to high physical workload, which may lead to early exit from nursing. To provide an overview of interventions preventing physical health problems in early career, a systematic review was performed. A comprehensive search of the literature was conducted up to December 2017. Primary outcome of interest was education/work dropout. Secondary outcomes were musculoskeletal symptoms. Independent authors selected studies, appraised quality and extracted data. After screening 7111 titles and abstracts, eleven studies were included. Seven studies evaluated interventions for moving/handling training. Four evaluated other interventions. None focused on our primary outcome education/work dropout. All studies reported on physical complaints among student nurses only. Overall, risk of bias was high and clinical heterogeneity prohibited pooling of data. Intervention effects were small and inconsistent. In conclusion, evidence for the effectiveness of interventions in the nursing curricula for the prevention/treatment of physical complaints is scarce and where available conflicting. We recommend high quality research on dropout due to physical health problems, as well as on the prevention/treatment of physical complaints.

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Tamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007-2012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 ± 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, p < 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, p = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09-1.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22-2.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81-1.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67-1.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.