Background: Jet injectors are advantageous over needle injectors by eliminating sharps hazards. The Government Accountability Office estimates 29% preventable sharp injuries with an estimated direct cost of more than $500 million out of the CDC's reported incidence of 385,000 needle stick injuries per year among US hospital healthcare workers. Yet the forces required to set and trigger devices using spring mechanisms for medication delivery have not been explored. This laboratory experiment measured forces exerted by healthcare workers (HCWs) using a particular jet injector approved by FDA in 2011. Objectives: In order to quantify the ergonomic impact on HCWs using a needle-free injector, the first objective was to evaluate the dynamic forces required to activate the trigger injector button and the reset station for the injector, with their respective means, for each of the parameters studied. The second objective was to compare these forces to those required to use four previously analyzed retractable intramuscular syringes with needles. Finally, the third objective was to assess potential psychophysics ergonomic impact on HCWs with use of these devices to formulate future design changes and recommendations for manufacturers and HCWs, respectively. Methods: This laboratory experiment was conducted through a multi-disciplinary team approach. It included a total of 136 trials (10 validation trials, 116 experimental trials and 10 padded trials for soft tissue simulation), which were conducted using the PharmaJetTM Injector. A force gauge and a load cell were integrated into the triggering setup and reset station, correspondingly, enabling force measurements to be obtained directly from the human-machine interfaces. These force data allowed for observations of force profiles in time by the healthcare worker as researcher while preparing for and administering injections. Data collection used three software applications for force conversions and data manipulation. Data were analyzed using descriptive statistics and analytical results by using ANOVA for the trigger injector & reset station with multiple comparison tests for parametric and non-parametric distributions, respectively. Results: The descriptive results indicated an average force for triggering the injector in the 116 trials was 15.92 lbs. (70.8 N) with a range of 9.77-26.46 lbs. (43.46-117.69 N). The measured forces for the reset station ranged from 5.35-82.78 lbs. (5.35-368.22 N) with an average of 25.32 lbs. (112.62 N) (SD 12.36). Spurious findings presented with tensile forces to fill the syringes resulting in hand strain in the first metacarpal joint after repetitive pinprick motion. The analytical results showed an ANOVA for trigger injector with a parametric-normal distribution with an F (2,133) Ratio 10.0472, p- value (F) 0.0001<0.05, showing statistical significance and with a Tukey's comparison test showing a significant difference in between the means of the padded trials vs. the validation & experimental trial groups. The ANOVA for the reset station showed a Kruskal Wallis H-statistic of 0.2568, p-value (H) 0.8795>0.05 presenting NO statistical significance with a Dunn's comparison test confirming NO difference in between the medians or mean ranks of all three groups. Conclusions: Triggering the injector and resetting the station required considerable effort in comparison to activating 4 retractable intramuscular syringes with needles from our previous studies, the range of mean forces were 3.63-17 lbs (16.19-77.53 N) for those syringes with the trigger injector maximum voluntary force of 71 N being above the recommend 56.6 N.The jet injector required more force per effort than 2 (4.4x) syringes & similar to other 2 syringes (0.9x) previously tested when considering the compression forces related with the trigger injector. Additional vector forces (displacement & gripping of reset station) could increase the cumulative effort affecting different musculoskeletal components when the whole components of the procedure are taken into account. Suggestions for the manufacturer regarding design changes to facilitate HCWs' use of this device are warranted, since some of the summation forces during the 12 mini-steps could be avoided to achieve a higher efficiency. This information may be useful for health care facilities when choosing devices to protect their workers from ergonomic injuries.

Bakgrund: Tidigare studier har påvisat att exponeringen av fysiskbelastning inom soldatyrket har ökat genom åren. Det finns samband mellan hög belastningen och förekomst av muskuloskeletala besvär och skador (MSBS). Syfte: Syftet med studien var att undersöka förekomsten av muskuloskeletala besvär och skador i två insatsgrupper inom Försvarsmakten med tio års mellanrum (Insats 2002 och Insats 2012) samt undersöka om det föreligger skillnad mellan grupperna. Dessutom syftar studien till att undersöka hur soldater som har MSBS upplever sin hälsa. Material och metod: Tvärsnittsstudie med 896 soldater ur två internationella insatser med tio års mellanrum (Insats 2002 n= 573 och Insats 2012 n = 323). Datainsamlingen utfördes med en enkät före insats avseende MSBS samt upplevd hälsa. Resultat: Tidigare erfarna och aktuella MSBS rapporterades i högre grad hos Insats 2012 jämfört med Insats 2002. Båda grupperna skattade den upplevda hälsan högt. De som rapporterade pågående MSBS i Insats 2012 upplever sin kroppsliga hälsa signifikant lägre (p&lt;0,001) än de som inte har MSBS. Konklusion: Det förelåg anmärkningsvärt hög förekomst av MSBS i Insats 2012. Det är av största vikt att fortsätta kartlägga arbetskraven, arbetsförmågan och besvärsförekomst så att preventiva och reaktiva åtgärder kan vidtas. / Background: Previously studies have shown that exposure to heavy physical workloads in the military profession have increased through the years. There is a correlation between heavy physical workloads and the precence of musculoskeletal complaints and injuries (MSCI). Purpose: The aim with the study was to investigate the prevalence of MSCI in two groups in Swedish Armed Forces, ten years apart (Mission 2002 and Mission 2012) and examine if there is a difference between the groups. In addition the study aims to examine how the soldiers who reported MSCI perceived their health. Material and method: Cross-sectional survey including 896 soldiers from two international missions ten-years apart (Mission 2002 n=572 and Mission 2012 n=323). Data were collected through questionnaire before the international mission. Result: Both point prevalence and one-year prevalence of MSCI where reported to be higher in Mission 2012 compared with Mission 2002. Both groups estimated high levels of perceived health. Conclusion: Remarkable high prevalence of MSCI existed in year 2012. It is of importance to continue to identify work requirements, work capacity and prevalence of MSCI so that preventive and reactive measures can be taken.

Bakgrund: Återhämtning och nutrition är viktiga aspekter för att minimera risken för skador hos idrottare. Ett för lågt energiintag kan leda till flera negativa fysiologiska effekter då kroppens energibehov inte tillgodoses. Hos kvinnor är menstruationsdysfunktion (MD) ett vanligt symptom på långvarig låg energitillgänglighet och hög förekomst har främst rapporterats hos kvinnliga idrottare inom viktkänsliga idrotter såsom uthållighetsidrott. Syfte: Syftet med denna studie var därför att beskriva skadebilden hos svenska och danska kvinnliga landslagsidrottare på seniornivå samt undersöka eventuella samband mellan förekomst av skador och menstruation. Metod: Alla danska och svenska kvinnliga landslagsidrottare blev kontaktade per mejl och tillfrågade om deltagande via online-enkät där frågor om skador det senaste året och menstruation ingick. Deltagare blev klassificerade att ha MD om de uppgav att de aldrig haft menstruation, ingen menstruation de senaste tre månaderna, menstruationscykler med längre intervall än 35 dagar eller &lt;9 menstruationscykler de senaste 12 månaderna. Alla deltagare blev klassificerade som antingen icke-viktkänsliga (t.ex. bollsport) eller viktkänslig idrottare (t.ex. uthålligsidrott). Resultat: Totalt svarade 634 (25%) idrottare på enkäten. Den rapporterade skadeprevalensen under de senaste 12 månaderna för samtliga inkluderade deltagare var 57%. 30% av deltagarna blev klassificerade att ha MD med en högre förekomst i viktkänsliga idrotter (39% vs 24%; P = &lt;0,001). Deltagare med MD rapporterade fler skador under de senaste 12 månaderna (P = 0,004) och hade en högre risk för skada (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) samt högre risk för att ha varit långvarigt skadad (&gt;22 dagar) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) jämfört med deltagare med regelbunden menstruation. Deltagare från viktkänsliga idrotter hade en högre risk för skada (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) och högre risk för att ha varit långvarigt skadad (OR = 2,11; 95% CI = 1,38–3,24; P = &lt;0,001) jämfört med deltagare från icke-viktkänsliga idrotter. Konklusion: Resultaten indikerar att kvinnliga landslagsidrottare med självrapporterad MD har en ökad skaderisk, speciellt inom viktkänsliga idrotter som uthållighetsidrott. Menstruationsdysfunktion bör därför tas i beaktning då det har negativ inverkan på idrottares hälsa och prestation. Vidare finns det ett stort behov av mer kunskap för att implementera effektiva kön- och idrottsspecifika preventionsåtgärder. / Background: Recovery and nutrition are important aspects in order to minimize injury risk in athletes. Multiple negative physiological impairments have been recognized in athletes due to low energy intake. One common symptom of prolonged low energy availability in females is menstrual dysfunction (MD) and high prevalence has been reported mostly in female athletes in weight-sensitive sports like endurance sports. Aim: The aim of the present study was to describe injuries among Swedish and Danish female national team athletes and to investigate potential connections between injury prevalence and menstruation. Method: All Swedish and Danish national team athletes were invited via e-mail to complete an anonymous online survey, which held questions about injuries the past year and menstruation. Participants were classified with MD if they stated that they never had menstruation, no menstruation the last three months, menstruation cycles with longer intervals than 35 days or &lt;9 menstruation cycles the last 12 months. The participants were also divided in groups of non-weight sensitive athletes (e.g. ball game) or weight sensitive athletes (e.g. endurance sport). Results: A total of 634 (25%) athletes completed the survey. Among all participants an injury prevalence of 57% was observed and 30% were classified with MD. Higher prevalence of MD was reported in weight-sensitive sports (39% vs. 24%; P = &lt;0,001). Athletes with MD sustained more injuries (P = 0,004), reported higher risk of injury (OR = 1,52; 95% CI = 1,06–2,19; P = 0,024) and to be long-term injured (&gt;22 days) (OR = 1,87; 95% CI = 1,23–2,55; P = 0,003) compared to athletes with regular menstruation. In athletes from weight-sensitive sports a higher risk of injury was observed (OR = 1,50; 95% CI = 1,02–2,21; P = 0,039) and also to be long-term injured (OR = 2,11; 95% CI = 1,38–3,24; P = &lt;0,001) compared to athletes from non weight-sensitive sports. Conclusion: The result indicates that female national team athletes with self-reported MD have increased injury risk, especially in weight-sensitive sports like endurance sports. Menstrual dysfunction has a negative impact on both health and performance, and therefore athletes and coaches need to pay attention to menstrual function. More research is needed to implement effective sex and sport-specific preventive measures.

Objectives: Heavy lifting in nursing is highly associated with low back pain (LBP) and musculoskeletal injuries (MSI). We aimed to evaluate the impact of mechanical devices used for patient lifting and transferring on risk of LBP and MSI of health care personnel. Methods: We conducted a systematic review and meta-analysis. The literature search was performed during 1st and 12th September 2021 using 17 electronic databases and handsearching of bibliographies of included studies. Twenty studies were included in the qualitative synthesis and eight studies with in total 2087 participants in the meta-analysis. Dependent on the study design, risk of bias was assessed by Cochrane RoB 2.0, EPOC, and MINORS. We conducted random-effects meta-analyses assessing Hedges’s g and 95% CI of MSI rate, perceived LBP, and peak compressive spinal load. We calculated prediction intervals and conducted a cost-benefit analysis (CBA). Results: All outcomes showed significant, adjusted pooled effect sizes (MSI rate: g = 1.11, 95% CI 0.914–1.299; perceived LBP: g = 1.54, 95% CI −0.016–3.088; peak compressive spinal load: g = 1.04, 95% CI −0.315 to 2.391). True effect sizes in 95% of all comparable populations fell in the following prediction intervals: MSI rate = −1.07-3.28, perceived LBP = −0.522–3.594, and peak compressive spinal load = −15.49 to 17.57. CBA revealed cost-benefit ratios of 1.2 and 3.29 between cumulative total savings and investment costs of intervention. - Conclusions: Prediction intervals confirmed strong true effect sizes for MSI rate and perceived LBP in 95% of all comparable populations but not for peak compressive spinal load. Mechanical lifting and transferring devices displayed a favorable cost-benefit ratio and should be considered for clinical implementation.