Reported bruxism and restless legs syndrome in media personnel with or without irregular shift work

A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company with irregular shift work (n=750) and to an equal number of randomly selected controls in the same company with regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosocial status, stress, work satisfaction and performance, tobacco use, bruxism, and restless legs symptoms (RLS). The aim was to investigate among a multiprofessional media personnel the associations between reported bruxism and RLS, while simultaneously controlling the effects of gender, age, tobacco use, shift work, and dissatisfaction with current workshift schedule. The overall response rate was 58.3% (53.7% men). The response rate in the irregular shift work group was 82.3% (56.6% men) and in the regular daytime work group 34.3% (46.7% men). In the bivariate analyses, RLS was more prevalent in workers at either end of the studied age range (p<0.05). Self-reported frequent bruxism was significantly associated with younger age (p<0.05). Females reported RLS (11.4%) slightly more often than males (7.7%) (NS). In logistic regression, frequent bruxism (p<0.05) and older age (p<0.05) were significantly positively associated with RLS. Dissatisfaction with one's current workshift schedule (p<0.05) and RLS (p<0.05) were significantly positively associated with frequent bruxism, while age (p<0.05) was significantly negatively associated. In conclusion, perceived bruxism may be a sign of a stressful situation or dissatisfaction, while RLS as a more stable trait may in itself negatively affect sleep quality and further enhance the problem.     

Associations of perceived pain and painless TMD-related symptoms with alexithymia and depressive mood in media personnel with or without irregular shift work

The aim of the present study was to analyze whether previously emerged pain symptoms and painless temporomandibular disorder (TMD) symptoms are associated with alexithymia and self-rated depression among media personnel in or not in irregular shift work. A standardized questionnaire was mailed to all employees of the Finnish Broadcasting Company in irregular shift work (n = 750) and to an equal number of randomly selected controls in regular 8-h daytime work. The questionnaire covered demographic items, employment details, general health experience, physical status, psychosomatic symptoms, psychosocial status, stress, work satisfaction and performance, and health-care use. Studied age groups, marital status, gender or perceived health were not significantly associated with alexithymia in the bivariate analyses. Most studied painless TMD symptoms associated significantly with alexithymia. Alexithymia was also significantly more prevalent among those who reported having more often than average neck pain (P < 0.05), head pain (P < 0.05), and tender teeth (P < 0.01). According to logistic regression, the probability of alexithymia was significantly positively associated with pain symptoms (P < 0.05) and painless TMD-related symptoms (P < 0.01), and significantly negatively associated with female gender (P < 0.01). Additionally, depressive mood was significantly positively associated with dissatisfaction of one's work-shift schedule (P < 0.05), and poorer health experience (P < 0.01). Neither alexithymia nor depression was associated with irregular shift work in itself. In conclusion, depressive mood may be a sign of dissatisfaction and impaired well-being. In the case of perhaps less disabling but common physical symptoms alexithymia as a possible underlying factor may be relevant in the diagnosis and management of such disorders.     

Persistent postsurgical pain in a general population: prevalence and predictors in the Tromsø study

Population-based data on the prevalence of persistent postsurgical pain are scarce. This study aimed to assess the prevalence of persistent postsurgical pain in a general population and to describe associated physical, social, and psychological factors, including symptoms of nerve injury and sensitization. A cross-sectional survey was performed in northern Norway with questionnaire items covering surgery, pain, and sensory abnormalities in the area of surgery. Of the 12,982 participants, 24.0% (3111) had undergone one or more surgical procedures during the 3 years preceding the survey. Of these, 2043 had the surgery performed more than 3 months before the investigation. Persistent pain in the area of surgery was reported by 40.4% of the patients (826 of 2043), moderate or severe pain by 18.3% (373 of 2043). Hypoesthesia, hyperesthesia, or both was reported by 24.5% (501 of 2043). There were strong associations between sensory abnormalities and persistent pain, increasingly with higher pain intensities; odds ratios were 2.68 for hypoesthesia and 6.27 for hyperesthesia. Of the 826 individuals reporting persistent pain in the anatomical area of surgery, 51.0% reported chronic pain when questioned without specific reference to the surgery. The present study supports evidence from clinical studies of persistent postsurgical pain, indicating a high prevalence, but reveals large discrepancies in report of pain, depending on the questions asked and the context in which the questions are presented. Strong associations between sensory abnormalities and pain indicate neuropathic mechanisms in a major proportion of cases.     

User involvement in hospital wards: professionals negotiating user knowledge. A qualitative study

Objective

To investigate how health professionals in hospital wards that have voluntarily initiated user involvement negotiate user knowledge into their professional knowledge.

Methods

Qualitative interviews were conducted with 18 health professionals from 12 hospital wards in Central Norway.

Results

The main value to health professionals of initiating user involvement was gaining access to user knowledge. Two functions of user knowledge were identified – user knowledge as an alternative to professional knowledge and user knowledge as support for professional knowledge. The need for good professional practice was used as an argument for closing professional fields to user involvement. Professionals were also under scrutiny from other discourses, such as scientific–bureaucratic medicine, which had a strong impact on how user involvement was carried out.

Conclusion

Health professionals saw knowledge transfer as valuable, but ultimately valued professional knowledge above user knowledge.

Practice implications

Even health personnel who embrace user involvement limit the influence of user knowledge on their own professional work. It seems necessary that user involvement be included in health policy and practice guidelines at hospital wards, if it is desirable that user knowledge influence professional knowledge and everyday work.     

Observational studies of a one year self-management program and a two year pulmonary rehabilitation program in patients with COPD

Objective:

To describe the outcome of a one year self-management program (SMG) and a two year pulmonary rehabilitation program (PRG).

Methods:

Two open prospective observational studies with 30 patients in each study. SMG had 46 hours over 12 months. PRG had in addition three weekly exercise sessions parallel which lasted an additional year.

Results:

In SMG, health-related quality of life (HRQoL, measured by St. George’s Respiratory Questionnaire) had an improvement of −3.6 points (95% CI −6.7 to −0.5) one year after the end of the intervention, but there was no change in the six minutes walking test (6MWT). The PRG had an improvement in HRQoL at the end of the intervention of −11.2 points (95% CI −13.9 to −8.4) and the 6MWT was clinically significant improved with 86 metres (95% CI 63 to 109). None of the groups showed any clinical relevant change in lung function.

Conclusion:

Participants in the SMG had had an improvement in quality of life and no deterioration in exercise tolerance one year after the end of the program compared to the start. Participants in the PRG significantly improved their quality of life and exercise tolerance the first year, but had no further clinical relevant improvement the second year.