Occupational ergonomic factors (OEF) include physical exertion, demanding posture, repetitive work, hand-arm vibration, kneeling or squatting, rising, and climbing, which are risk factors for ...low-back pain (LBP). This study aimed to examine the prevalence, years lived with disability (YLD), healthcare costs, and productivity losses of LBP attributable to OEF by age, sex, World Health Organization region, and country in 2019.
In this cross-sectional study, prevalence and YLD were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. Employment statistics were obtained from the International Labor Organization websites. Health and economic impact was estimated for 192 countries and territories using the population attributable fraction method.
Globally, OEF were responsible for 126.1 million prevalent cases of LBP and 15.1 million YLD in the working-age population (aged 15-84 years) in 2019, with the Western Pacific region suffering most. OEF-attributable LBP led to $216.1 billion of economic losses worldwide. Of these, $47.0 billion were paid in healthcare costs, with the public sector serving as the largest contributor (59.2%). High-income countries bore >70% of global economic burden, whereas middle-income countries experienced >70% of global YLD. Generally, more prevalent cases and healthcare costs were found among females, whereas more YLD, productivity losses, and total costs were found among males.
Globally, OEF-attributable LBP presented a heavy burden on health and economic systems. Exercise together with education, active monitoring, evidence-based medical practices, alternative cost-effective solutions, and prioritizing health policies are needed.
Limited studies exist on women’s mild traumatic brain injury received from episode of intimate partner violence. This study aims to identify the occurrence of intimate partner violence‐related mild ...traumatic brain injury in Chinese women admitted to emergency units; and examine the physical, mental, and cognitive functioning of abused women with mild traumatic brain injury related to violent episodes. Eighty‐six Chinese abused women presenting at emergency units in four major local hospitals in Hong Kong between January 2014 and December 2016 were recruited. They were admitted for the treatment of intimate partner violence‐related physical injuries and were screened for traumatic brain injury by the emergency unit nurses at triage. Participants were assessed for traumatic brain injury based on the definition from US Center for Disease Control and Prevention, post‐concussion physical symptoms, anxiety and depression, health‐related quality of life, and cognitive functioning. Structured multiphase regression was used to examine the impact of intimate partner violence‐related mild traumatic brain injury on physical, mental, and cognitive functioning of participants. We found that 24.4% of participants had intimate partner violence‐related mild traumatic brain injury. There were significantly more severe post‐concussion physical symptoms in abused women with intimate partner violence‐related mild traumatic brain injury than those without mild traumatic brain injury (estimate = 18.7, 95% CI = 10.9 to 26.6, p < 0.001). The Mental Component Summary was also significantly associated with intimate partner violence‐related mild traumatic brain injury (estimate = ‐7.9, 95% CI = ‐13.8 to ‐2.1, p = 0.009). Regarding cognitive functioning, the mean total test scores indicated that both groups were cognitively abnormal and there was no significant impact from mild traumatic brain injury. This study provides evidence on the impact of mild traumatic brain injury and implications in screening for mild traumatic brain injury and early intervention for improving quality of life in abused women.
Aim
The aim of this study was to explore the relationship between workplace bullying and mental health, focusing on the indirect effect of post‐traumatic stress responses and moderation of nurses' ...perception of workplace bullying.
Background
Post‐traumatic stress symptoms frequently result from workplace bullying, but how nurses' individual appraisals relate to negative consequences is unclear.
Method
A cross‐sectional online survey was conducted with 319 Korean nurses; participants were divided into the perceived and non‐perceived workplace bullying groups. Moderated mediation models were tested using structural equation modelling with Stata version 16.
Results
Regardless of nurses' appraisals, higher levels of workplace bullying were associated with poor mental health. Post‐traumatic stress symptoms indirectly impacted the relationship in both groups, but post‐traumatic growth did not. The perceived group showed a partial negative association between post‐traumatic growth and mental health.
Conclusion
It is necessary to develop systems for early detection of mental health problems to create safe work environments not only for nurses who perceive workplace bullying but also for those who do not.
Implications for Nursing Management
Staff education and institutional support that consider PTSS are recommended for all nurses.
•Many studies on screen time and sleep problems were cross-sectional.•We leveraged a smartphone-based daily assessment study.•Between person, higher mobile gaming time had bidirectional associations ...with short sleep duration and insomnia symptoms.•Within person, insomnia symptoms increased next-day mobile gaming time.
To explore associations of screen time (total, mobile gaming) with sleep problems in Chinese young adults.
This was a 4-week daily morning (completion rate = 82.1%, 909/1107) and evening (completion rate = 92.4%, 1061/1148) assessment study in 41 university students (22 female, mean age = 22.3 SD 4.2 years). Short sleep duration < 7 h, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and any of these three insomnia symptoms were self-reported in the morning. Mobile gaming time was self-reported in the evening, whilst total screen time was objectively tracked. Bayesian multilevel mixed-effects modeling disaggregated between- and within-person associations.
Between person, longer mobile gaming time predicted short sleep duration (adjusted odds ratio AOR = 1.90, 95% CI 1.39, 2.69), any insomnia symptoms (AOR = 1.59, 95% CI 1.20, 2.11), difficulty initiating sleep (AOR = 3.05, 95% CI 1.51, 6.24), and difficulty maintaining sleep (AOR = 2.19, 95% CI 1.18, 3.74). Short sleep duration (adjusted b = 0.99, 95% CI 0.05, 1.95), any insomnia symptoms (adjusted b = 1.19, 95% CI 0.24, 1.94), and difficulty initiating sleep (adjusted b = 1.72, 95% CI 0.11, 3.19) reversely increased mobile gaming time. Within person, any insomnia symptoms (adjusted b = 0.17, 95% CI 0.04, 0.31) and early morning awakening (adjusted b = 0.28, 95% CI 0.08, 0.48) increased next-day mobile gaming time. Total screen time was not associated with sleep problems both between and within person.
Bidirectional between-person associations of mobile gaming time with short sleep duration and insomnia symptoms informed multiple-health-behavior-change interventions. Unidirectional within-person associations of insomnia symptoms with next-day mobile gaming time informed just-in-time adaptive interventions addressing daily variations in insomnia symptoms.
250/250 word limits
Young mothers face considerable challenges that can affect their mental health, with anxiety being one of the most common mental health problems observed in this population. Furthermore, pregnancy is ...one of the risk factors for intimate partner violence (IPV). There is thus an urgent need to explore the IPV risk faced by young mothers and its association with their mental health, anxiety in particular. The study aimed to investigate the correlation between IPV victimization and anxiety in young mothers, as well as the protective effects of social support and resilience. A total of 79 young Chinese mothers aged 16 to 25 were recruited from a special service project for young parents in Hong Kong. Just more than half (50.6%) were found to have experienced psychological aggression by their current partner, with 26.6% and 13.9%, respectively, having experienced physical assault and sexual abuse. Roughly a quarter (25.3%) perceived themselves to suffer from moderate or severe generalized anxiety disorder. Logistic regression further showed the young mothers who had experienced physical assault and/or sexual abuse by their current partners to be at least six times likelier to have moderate or severe anxiety disorder (adjusted odds ratio aOR = 4.51, p < .05) than those who had experienced no such violence. Young mothers with less perceived social support (aOR = 0.77, p < .01), a lower secondary level of education or below (aOR = 12.99, p < .05), and in receipt of social security assistance (aOR = 5.69, p < .05) were also likelier to have moderate or severe anxiety disorder. The results indicate the importance of social support during the critical period of young motherhood. Health care professionals need to remain alert to the impacts of IPV victimization and the risk of anxiety in young mothers with a low level of education and/or receiving financial support.
Ethnic minorities across the globe encounter disparities in healthcare. While a great deal of research has been conducted on the experiences of these patients, studies focusing on the perspectives of ...healthcare professionals are limited, particularly in the context of Asia. This study explores the perceptions of and challenges faced by Hong Kong healthcare professionals in the provision of culturally appropriate care to South Asian ethnic minority patients. Taking a qualitative approach, interviews were conducted with 22 healthcare professionals. Two main themes were identified: ‘lack of support’ at the healthcare system level and ‘dysfunctional relationship with South Asian ethnic minority patients’ at the interpersonal level. Challenges at the healthcare system level include information outreach, cultural competency, utilisation of available resources and time and workload, whereas challenges at the interpersonal level include patient–provider interaction, patient–provider perceptions of illness and care and patient–provider sociocultural discordance. Intercultural care was found to be influenced by both the healthcare system and interpersonal characteristics. The study highlights the need for healthcare professional education and training in cultural competency, in order to improve the provision of intercultural care. Identifying the challenges faced by healthcare professionals and the implications of these challenges for the provision of healthcare to South Asian ethnic minority patients will help practitioners, policy makers and care provider agencies to improve quality of care and health outcomes for culturally diverse patients.
To examine non-restorative sleep and its impact on quality of life (QOL) in Chinese adolescents, this cross-sectional study included 2827 students aged 12–20 who were selected from 15 secondary ...schools in Hong Kong, China. Non-restorative sleep was assessed by a single item, rated on a 0–10 scale: “To what extent did you feel refreshed upon awakening over the past month?”. QOL was evaluated by the World Health Organization Quality of Life Measure—Abbreviated Version Hong Kong Chinese Version. Univariable and multivariable linear mixed-effects regressions were conducted to examine the influence of non-restorative sleep (NRS) on QOL. In the present sample, the mean overall QOL was 13.83, and the extent of feeling refreshed upon awakening was 4.75 on average. In multivariable linear mixed-effects regression, one unit feeling less refreshed upon awakening was associated with 0.37 units of poorer overall QOL after adjusting for age, gender, medical conditions, parental education and occupation, weekly hours of aerobic exercises, smoking and drinking habits. Additionally, adolescents with a significantly poorer overall QOL were more likely to be older, have medical problems, have parents with an educational level of primary school or below, have an unemployed father, engage in less weekly aerobic exercise, and be current smokers or former drinkers. Adolescents who experienced non-restorative sleep had a poorer QOL. Future studies are needed to alleviate non-restorative sleep to improve health outcomes in adolescents.
Smartphone dating applications (apps) have become popular in recent years. However, the association between the use of dating apps and sexual abuse remains uninvestigated. The aim of this study was ...to examine the association between using dating apps and the sexual abuse of males and females. Six hundred sixty-six participants were recruited in four universities in Hong Kong in 2015. Overall, the 1-year prevalence of sexual abuse was 12.4% (95% confidence interval CI: 9.8, 14.9) and the lifetime prevalence was 14.2% (95% CI: 11.5, 16.9). Multiple logistic regressions found that users of dating apps (adjusted odds ratio aOR: 2.13, p < .05) were more likely to be sexually abused in the past year than non-users. Using dating apps was also a risk factor of lifetime sexual abuse (aOR: 1.83, p < .05). Our findings suggest that app users should deserve more attention in risk assessment, risk stratification, and sexual abuse prevention programs.
Intimate partner violence (IPV) has recently been recognised as a global public health issue that can cause various kinds of long‐lasting physical, sexual and psychological health problems. Limited ...studies are available concerning the relationship between objective and subjective socioeconomic status (SES) and IPV, and the impact of experiencing IPV on health consequences. This is a cross‐sectional study aiming to examine the association between objective and subjective SES as risk factors of IPV, and further investigate how they affect health status in adults who experienced IPV. A total of 400 participants were recruited from June to September 2016 among 18 districts in Hong Kong. Results from multiple linear regression showed that having a higher education (adjusted B aB = 0.22, 95% CI = 0.01, 0.45), having lower levels of subjective SES (aB = −0.08, 95% CI = −0.15, −0.01), experiencing childhood stress (aB = 0.58, 95% CI = 0.27, 0.89) and being married (aB = 0.60, 95% CI = 0.01, 1.19) were significantly associated with IPV. While employment and household income were not associated with IPV. Participants with higher levels of subjective SES were more likely to report somatic symptom (aB = −0.44, 95% CI = −0.87, −0.02), anxiety (aB = −0.38, 95% CI = −0.72, −0.04) and depressive symptom (aB = −0.52, 95% CI = −0.94, −0.10). Low subjective SES, instead of low objective SES, was found associated with IPV in Chinese adults. A priority for future studies is the confirmation and expansion of subjective SES and its function in clinical measures. Programmes instilling hope and optimism will be helpful to enhance subjective SES and boost physical and mental well‐being in IPV survivors.
IMPORTANCE: The degree to which health and economic outcomes of musculoskeletal disorders are attributable to high body mass index (BMI) has not been quantified on a global scale. OBJECTIVE: To ...estimate global health and economic outcomes associated with musculoskeletal disorders—low back pain (LBP), gout, and osteoarthritis attributable to high BMI in 2019. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data of 192 countries and territories from the Global Burden of Diseases, Injuries, and Risk Factors Study, World Health Organization Global Health Expenditure, World Bank, and International Labour Organization databases. Data analyses were conducted from February 24 to June 16, 2022. MAIN OUTCOMES AND MEASURES: Prevalence, years lived with disability (YLDs), health care costs, and productivity losses due to morbidity from LBP, gout, and osteoarthritis attributable to high BMI by region and country. Prevalence and YLDs were calculated with the population attributable fraction approach. The economic burden, including health care costs and productivity losses due to morbidity, was also quantified. Health care costs borne by the public, private, and out-of-pocket sectors were estimated based on their corresponding payment shares. Productivity losses were estimated based on the output per worker. A sensitivity analysis was conducted to arrive at the base, minimum, and maximum estimates (ie, uncertainty interval UI) by using the mean, lower, and upper bounds of all input variables. RESULTS: High BMI was estimated to be responsible for 36.3 million (UI, 18.4-61.0 million), 16.9 million (UI, 7.5-32.5 million), and 73.0 million (UI, 32.4-131.1 million) prevalent cases of LBP, gout, and osteoarthritis, respectively, which accounted for 7.3 million (UI, 3.0-15.0 million) YLDs across 192 countries and territories in 2019. Globally, the YLDs of musculoskeletal disorders attributable to high BMI accounted for 1.0% of all-cause YLDs in the working-age population aged 15 to 84 years. The global total costs of musculoskeletal disorders attributable to high BMI reached $180.7 billion (UI, $83.8-$333.1 billion), including $60.5 billion (UI, $30.7-$100.5 billion) in health care costs and $120.2 billion (UI, $53.1-$232.7 billion) in productivity losses. In terms of the global health care costs, 58.9% ($35.6 billion; UI, $17.8-$59.6 billion) was borne by the public sector, 24.0% ($14.5 billion; UI, $7.8-$23.2 billion) by the private sector, and 17.1% ($10.3 billion; UI, $5.1-$17.6 billion) by the out-of-pocket sector. On average, the total costs accounted for 0.2% of global gross domestic product. Great inequalities in the disease and economic burden existed across regions and countries. Nearly 80% of global health care (82.4%) and morbidity-related costs (82.9%) were paid by high-income countries, whereas more than 60% (61.4%) of global YLDs occurred in middle-income countries. CONCLUSIONS AND RELEVANCE: In this cross-sectional study of 192 countries and territories, a substantial amount of the health and economic impact of musculoskeletal disorders was attributable to high BMI. Developing effective policies and active participation from health professionals to prevent excessive weight gain are needed. More available estimates are also needed to facilitate a global analysis.
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