Midwives' thoughts about musculoskeletal disorders with an evaluation of working tasks.

The prevalence of musculoskeletal disorders is very high amongmidwives resulting in sickness absenteeism, functional limitation and staff shortages. There are several contributory risk factors having impact on the development of MSDs. This study aimed to (1) explore midwives' experiences and views about work-related MSDs and contributing risk factors, and (2) analyse working postures for musculoskeletal injury risks. A mixed method approach was used with interviews/focus group (n = 15/7) and observations (n = 22) of specific tasks (during birth and after birth) using the posture analysis observational method (Rapid Entire Body Assessment, REBA). The participants were midwives who had an active role in the United Kingdom (UK) National Health Services (NHS). It was found that MSDs were often attributed to the physical (working in awkward positions), organisational (longer shift hours, fewer staff, increased work load), psychosocial (defensive practice, higher demand) challenges of midwifery. All postures had very high to medium REBA risk levels with action categories indicating that action or further assessment is definitely necessary to reduce MSDs. This research provides a holistic approach by analysing risk factors and interactions in the work context to inform the development of risk management strategies. Midwifery working conditions have a big impact on developing musculoskeletal symptoms. Management of such symptoms will improve staff wellbeing, mother and baby safety, individuals' life trajectories and staff shortages.

Midwives are getting hurt: UK survey of the prevalence and risk factors for developing musculoskeletal symptoms.

OBJECTIVE: To investigate the prevalence, severity and impact of musculoskeletal disorders (MSDs) and to explore individual, work-related and psychosocial risk factors DESIGN: A cross sectional survey SETTING: A self-reported online questionnaire was used to collect data over seven months (May-December 2016). PARTICIPANTS: The survey was distributed to midwives across the United Kingdom through the Consultant Midwives Network and the Royal College of Midwives. MEASUREMENTS AND FINDINGS: Prevalence, severity and impact (12-month) of MSDs for nine body parts are presented. The associations between individual, occupational and psychosocial factors and symptoms are examined using Independent samples t-test or Chi-square statistical analyses, with Logistic regression analysis to understand the relative importance of variables. It was found that 92% of the participants reported MSDs, most commonly in the low back (71%), neck (45%) and shoulders (45%). Symptoms impacted on normal activities at work and/or leisure (50%), sick leave (30%) and jobs/duties (45%). Age and time practicing in midwifery were inversely associated with low back symptoms; reported less frequently with increasing age and experience. Longer working hours was a predictor for shoulder symptoms. Over commitment (intrinsic job stress) was associated with neck and more strongly with shoulder symptoms. Those caring for a dependent adult for more than 50 h a week were 4.54 times more likely to have neck discomfort. KEY CONCLUSIONS: This first survey of UK Midwives reveals a very high prevalence of low back, neck and shoulder symptoms, resulting in sickness absenteeism, reduction in normal activities and changing roles. Age, years in practice, body mass index, working hours, job satisfaction and job stress are contributory factors. IMPLICATIONS FOR PRACTICE: This study highlights the prevalence and impact of musculoskeletal symptoms and the potential harmful impacts on their working life and patient care. The findings will promote risk-awareness and national actions for risk management.

Work-related musculoskeletal injuries amongst obstetrics and gynaecology trainees in East Midland region of the UK.

PURPOSE: Work-related musculoskeletal injuries (WRMSI) have been well known amongst obstetrics and gynaecology (O&G) practitioners, but limited data have been reported. Our aim is to determine the prevalence, severity and characteristics of WRMSI amongst O&G trainees. METHODS: A musculoskeletal ergonomic survey was conducted amongst the O&G trainees in the East-Midlands region of United Kingdom (UK). The survey comprised of demographic details, year of training, previous manual handling training, any work-related orthopaedic injury, the type of injury, any treatment received in addition to any sick leave incurred after the injury were also documented. RESULTS: The response rate for the survey was 76% (59/78). The majority (22%) were senior specialist trainee, seventh year (ST7) and between 30 and 34 age groups. Approximately 90% of the trainees reported to have experienced pain in the last year. The most common site was the back, which was followed by the shoulders and the upper limbs. 63% of trainees reported injuries that were attributed to WRMSI. One in ten of the trainees needed time off work due to injury. A total of 20 days were lost in the last 12 months as a result of pain or discomfort attributed to obstetric work. CONCLUSIONS: Our results demonstrate the prevalence of work-related injuries and its detrimental effects. Such injuries are underreported on incident reporting system. Ergonomics and WRMSI prevention in obstetrics and gynaecology is an area seldom discussed. Obstetric training sessions should incorporate ergonomic interventions. Further research is required to establish relevant aetiological factors related to WRMSI in this specialty.

Enhancement of rat bladder contraction by artificial sweeteners via increased extracellular Ca2+ influx.

INTRODUCTION: Consumption of carbonated soft drinks has been shown to be independently associated with the development of overactive bladder symptoms (OR 1.62, 95% CI 1.18, 2.22) [Dallosso, H.M., McGrother, C.W., Matthews, R.J., Donaldson, M.M.K., 2003. The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women. BJU Int. 92, 69-77]. We evaluated the effects of three artificial sweeteners, acesulfame K, aspartame and sodium saccharin, on the contractile response of isolated rat detrusor muscle strips. METHODS: Strips of detrusor muscle were placed in an organ bath and stimulated with electrical field stimulation (EFS) in the absence and presence of atropine, and with alpha,beta methylene ATP, potassium, calcium and carbachol. RESULTS: Sweeteners 10(-7) M to 10(-2) M enhanced the contractile response to 10 Hz EFS compared to control (p<0.01). The atropine-resistant response to EFS was marginally increased by acesulfame K 10(-6) M, aspartame 10(-7) M and sodium saccharin 10(-7) M. Acesulfame K 10(-6) M increased the maximum contractile response to alpha,beta methylene ATP by 35% (+/-9.6%) (p<0.05) and to KCl by 12% (+/-3.1%) (p<0.01). Sodium saccharin also increased the response to KCl by 37% (+/-15.2%) (p<0.05). These sweeteners shifted the calcium concentration-response curves to the left. Acesulfame K 10(-6) M increased the log EC(50) from -2.79 (+/-0.037) to -3.03 (+/-0.048, p<0.01) and sodium saccharin 10(-7) M from -2.74 (+/-0.03) to 2.86 (+/-0.031, p<0.05). The sweeteners had no significant effect on the contractile response to carbachol but they did increase the amplitude of spontaneous bladder contractions. DISCUSSION: These results suggest that low concentrations of artificial sweeteners enhanced detrusor muscle contraction via modulation of L-type Ca(+2) channels.