The Flares of Low back pain with Activity Research Study (FLAReS): study protocol for a case-crossover study nested within a cohort study.

BACKGROUND: Although it is generally accepted that physical activity and flares of low back pain (LBP) are related, evidence for the directionality of this association is mixed. The Flares of Low back pain with Activity Research Study (FLAReS) takes a novel approach to distinguish the short-term effects of specific physical activities on LBP flares from the cumulative effects of such activities, by conducting a longitudinal case-crossover study nested within a cohort study. The first aim is to estimate the short-term effects (≤ 24 h) of specific physical activities on LBP flares among Veterans in primary care in the Veterans Affairs healthcare system. The second aim is to estimate the cumulative effects of specific activities on LBP-related functional limitations at 1-year follow-up. METHODS: Up to 550 adults of working age (18-65 years) seen for LBP in primary care complete up to 36 "Scheduled" surveys over 1-year follow-up, and also complete unscheduled "Flare Window" surveys after the onset of new flares. Each survey asks about current flares and other factors associated with LBP. Surveys also inquire about activity exposures over the 24 h, and 2 h, prior to the time of survey completion (during non-flare periods) or prior to the time of flare onset (during flares). Other questions evaluate the number, intensity, duration, and/or other characteristics of activity exposures. Other exposures include factors related to mood, lifestyle, exercise, concurrent treatments, and injuries. Some participants wear actigraphy devices for weeks 1-4 of the study. The first aim will examine associations between 10 specific activity categories and participant-reported flares over 1-year follow-up. The second aim will examine associations between the frequency of exposure to 10 activity categories over weeks 1-4 of follow-up and long-term functional limitations at 12 months. All analyses will use a biopsychosocial framework accounting for potential confounders and effect modifiers. DISCUSSION: FLAReS will provide empirically derived estimates of both the short-term and cumulative effects of specific physical activities for Veterans with LBP, helping to better understand the role of physical activities in those with LBP. TRIAL REGISTRATION: ClinicalTrials.gov NCT04828330 , registered April 2, 2021.

Pet owners' perceptions of veterinary safety practices.

Veterinary workers must care for their animal patients while simultaneously protecting their own health and safety. This process can be complicated by the presence and perception of pet owners who may not agree with a given tactic used to protect veterinary workers from injury. We conducted focus groups of pet owners in the Seattle area during November 2016 to gain a deeper understanding of their perceptions relating to veterinary worker safety practices. Focus group interviews were recorded and transcribed and study themes identified and summarised. Twenty pet owners participated in three focus groups. Study themes arising from the focus group discussions could be categorised into human, animal, behavioural and environmental domains as outlined in a One Health Occupational Safety and Health (OHOSH) model. Communication was a recurring study theme identified, suggesting that lacking or impaired veterinary personnel-client communication plays a key role in the safe delivery of veterinary services and can negatively impact the use of safety practices among veterinary personnel. Our study suggests that it is important for veterinary personnel to communicate to clients the reasons for policies related to worker safety. Such communication can help engage the veterinary client in order to effectively avoid situations that precipitate injury.