A randomized trial on elderly laypersons' CPR performance in a realistic cardiac arrest simulation.

BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is important for survival after cardiac arrest. We hypothesized that elderly laypersons would perform CPR poorer in a realistic cardiac arrest simulation, compared to a traditional test. METHODS: Sixty-four lay rescuers aged 50-75 were randomized to realistic or traditional test, both with ten minutes of telephone assisted CPR. Realistic simulation started suddenly without warning, leaving the test subject alone in a confined and noisy apartment. Traditional test was conducted in a spacious and calm classroom with a researcher present. CPR performance was recorded with a manikin with human like chest properties. Heart rate and self-reported exhaustion were registered. RESULTS: CPR quality was not different in the two groups: compression depth, 43 mm ± 7 versus 43 ± 4, P = 0.72; compressions rate, 97 min(-1) ± 11 versus 93 ± 15, P = 0.26; ventilation rate, 2.4 min(-1) ± 1.7 versus 2.8 ± 1.1, P = 0.35; and hands-off time 273 s ± 50 versus 270 ± 66, P = 0.82; in realistic (n = 31) and traditional (n = 33) groups, respectively. No fatigue was evident in the repeated measures analysis of variance. Work load was not different between the groups; attained percentage of age predicted maximum heart rate, 73% ± 9 and 76 ± 11, P = 0.37, reported exhaustion 43 ± 21 (scale: 0 to 100) and 37 ± 19, P = 0.24. CONCLUSIONS: Elderly lay people are capable of performing chest compressions with acceptable quality for ten minutes in a realistic cardiac arrest simulation. Ventilation quality and hands-off time were not adequate in either group.

Comprehensive schoolteachers at risk of early exit from work.

Risk of early exit from work for teachers was operationalized as high burnout scores, working part-time due to heavy burden and illness or working part-time while also receiving partial disability pension. Data were collected by mailed questionnaires in a cross-sectional study to a random sample of Norwegian comprehensive schoolteachers, response rate = 86% (N = 1860 valid cases). High age increased the risk of early exit from work, but for cynicism the age effect disappeared when sense of competence and stress were introduced in the regression model. Age had no effect for low professional efficacy. Sense of competence effected burnout, but actual competence level and the gap between actual competence and teaching obligations did not. Stress effected all measures of risk of early exit, especially exhaustion. Change as stress factor increased the exhaustion scores, and were also relevant to risk of having a part-time position, and/or partial disability pension.

Assessment of musculoskeletal and other health complaints in female hospital staff.

Musculoskeletal and other health complaints were investigated in a sample of 586 female hospital staff. Health complaints, including musculoskeletal pain, were assessed by the Ursin Health Inventory (UHI). Factor analyses of the UHI favoured a seven-factor solution in which musculoskeletal pain emerged as an independent factor of complaints. Other complaint factors could be labelled lower digestive, upper digestive, cardiorespiratory, allergy, cold/influenza and headache. Factor analyses of the extended version of the Nordic Questionnaire (NQ-EV), which focuses specifically on musculoskeletal pain from nine body areas, favoured a three-factor solution in which complaints from the upper back, low back and extremities emerged as the independent factors. Product-moment coefficients of correlation between factor-based sum scores in the two survey measures stated that the UHI factor 'musculoskeletal pain' and the NQ-EV factor 'upper back' were significantly correlated. This indicated an orientation of the UHI 'musculoskeletal pain' factor to pain in the upper part of the back. Only very moderate coefficients of correlation emerged between the NQ-EV factor scores and the remaining UHI scores. The results support the assumption that musculoskeletal complaints are not closely related to other types of health complaints, and that musculoskeletal complaints among female hospital staff should be assessed with separate items for upper back (neck/shoulders), low back and the extremities.

[Health effects of physical activity and psychological training]. / Helsemessig effekt av fysisk aktivitet og psykologisk trening.

Skeletomuscular pain is a very frequent complaint. Most patients recover spontaneously, but in some this pain may become long-lasting or even chronic. This occurs only in a minority, but even so skeletomuscular pain is the most frequent reason for long-term sickness benefit and permanent disability in the present Norwegian population. This report reviews the results of a series of controlled studies in Norway demonstrating that such pain may be treated by several different methods. Positive effects have been demonstrated from aerobic physical training, stress management training, relaxation training, and combinations of these programmes. Interventions directed at the organisation of the work situation have also had positive effects. These effects include decrease of pain and of psychological and subjective health complaints. However, a comparison of the effects of the different types of treatment would have to be based on a large multicentre study.

[Connections between musculoskeletal complaints and personality]. / Sammenhenger mellom muskelplager og personlighetstrekk.

Modern research has demonstrated a weak association between level of muscle tension and experience of muscle pain. Anxiety and dysphoric over-responsiveness are the traditional psychogenic risk factors in muscle tension. Results from recent Norwegian research lend support to a more multidimensional causal understanding of muscle tension and of pain. Generally, personality factors were found to be a contributory cause of muscle pain of the neck and shoulders, whereas ergonomic load was found to be of greater significance for low back pain. Personality factors may induce patterns of skeletal muscle activation discrepant with characteristics of the skeletal muscle physiology: Preference for aerobic activities may develop through social learning, whereas the muscles may be genetically biased toward anaerobic activities. Furthermore, personality factors may be challenged by the work setting, and may result in mismatch that provokes muscle pain. Impatient expenditure of effort has appeared as a mediating personality risk factor among workers exposed to high ergonomic load, whereas dysphoric over-responsiveness mediated back pain primarily among staff exposed to high emotional load.