Sustaining work ability amongst female professional workers with long COVID.

BACKGROUND: Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than WA in men. Exploration of lived experiences could elucidate the WA support required. AIMS: To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks. METHODS: Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return to work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation. RESULTS: All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as facilitated by a professional role, rapid health care access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organizational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers' workforce diversity and competence would be protected and that workers would need to reciprocate flexibility. CONCLUSIONS: These qualitatively derived findings of workers' lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working-age adults with complex long-term health conditions.

What workers can tell us about post-COVID workability.

BACKGROUND: The apparent functional impact of post-COVID-19 syndrome has workability implications for large segments of the working-age population. AIMS: To understand obstacles and enablers around self-reported workability of workers following COVID-19, to better guide sustainable workplace accommodations. METHODS: An exploratory online survey comprising quantitative and qualitative questions was disseminated via social media and industry networks between December 2020 and February 2021, yielding usable responses from 145 workers. Qualitative data were subjected to content analysis. RESULTS: Over half of the sample (64%) were from the health, social care, and education sectors. Just under 15% had returned to work, and 53% and 50% reported their physical and psychological workability respectively as moderate at best. Leading workability obstacles were multi-level, comprising fatigue, the interaction between symptoms and job, lack of control over job pressures, inappropriate sickness absence management policies, and lack of COVID-aware organizational cultures. Self-management support, modified work, flexible co-developed graded return-to-work planning, and improved line management competency were advocated as key enablers. CONCLUSIONS: Assuming appropriate medical management of any pathophysiological complications of COVID-19, maintaining or regaining post-COVID workability might reasonably follow a typical biopsychosocial framework enhanced to cater to the fluctuating nature of the symptoms. This should entail flexible, regularly reviewed and longer-term return-to-work planning addressing multi-level workability obstacles, co-developed between workers and line managers, with support from human resources, occupational health professionals (OHP's), and a COVID-aware organizational culture.

Review of preventative behavioural interventions for dermal and respiratory hazards.

BACKGROUND: No previous systematic review of the evidence base has been undertaken to help occupational health professionals understand how to reliably lower the instance of occupational ill-health through reducing risk-taking behaviour. AIMS: To evaluate the effectiveness and processes of occupational-based behavioural interventions for workers exposed to dermal and respiratory hazards. METHODS: A systematic review was conducted. Sixteen electronic databases were searched using key words. Bibliography, health and safety websites and hand searches of key journals were also undertaken. Articles were included if they evaluated an intervention targeting workers' behavioural compliance, addressed dermal or respiratory hazards, used before and after measures with a control group comparison and used behaviour-related exposure indicators such as airborne exposure, health effects, behaviour observations and self-reported work practices. Data were extracted according to potential sources of bias, impact and behavioural change processes used. RESULTS: Ten of 550 articles identified as potentially relevant were included. A predominance of small effect sizes, particularly for larger samples, demonstrated limited but positive impact upon exposure. Studies contained too much heterogeneity for reliable meta-analysis. None of the studies covered the full range of behaviour change components necessary for reducing exposure risk. CONCLUSIONS: We conclude that future interventions could enhance their effectiveness through improving design quality, reporting and basing their content upon evidence-based behavioural change approaches. Using a comprehensive range of evidence-informed behaviour change ingredients should improve occupational health professional's ability to reliably reduce occupational ill-health where exposure cannot totally be designed out of the workplace.

Clinical database development: characterization of EEG phenotypes.

We propose development of evidence-based methods to guide clinical intervention in neurobehavioral syndromes based on categorization of individuals using both behavioral measures and quantification of the EEG (qEEG). Review of a large number of clinical EEG and qEEG studies suggests that it is plausible to identify a limited set of individual profiles that characterize the majority of the population. Statistical analysis has already been used to document "clusters" of qEEG features seen in populations of psychiatric patients. These clusters are considered here as intermediate phenotypes, based on genetics, and are reliable indices of brain function, not isomorphic with DSM categories, and carry implications for therapeutic intervention. We call for statistical analysis methods to be applied to a broad clinical database of individuals diagnosed with neurobehavioral disorders in order to empirically define clusters of individuals who may be responsive to specific neurophysiologically based treatment interventions, namely administration of psychoactive medication and/or EEG neurofeedback. A tentative set of qEEG profiles is proposed based on clinical observation and experience. Implication for intervention with medication and neurofeedback for individuals with these neurophysiological profiles and specific qEEG patterns is presented.

Metacarpal shaft fractures: the effect of shortening on the extensor tendon mechanism.

Spiral and oblique metacarpal shaft fractures frequently develop shortening through the fracture site. The acceptable amount of fracture shortening has not been well established. The goal of this study was to elucidate the acceptable limits of metacarpal shaft fracture shortening in a cadaver model by assessing the magnitude of the metacarpophalangeal (MCP) joint extensor lag produced. Nine fresh-frozen cadaver hands were used to create a metacarpal shaft fracture model in the second and fifth metacarpal bones. Sequential shortening up to 10 mm in 2-mm increments was performed. The results revealed an average of 7 degrees of extensor lag at the MCP joint produced for every 2 mm of metacarpal shortening. The capacity of the MCP joint for active hyperextension may compensate for the extensor lag produced by metacarpal shortening in the clinical setting.

Information in magnetic resonance images: evaluation of signal, noise and contrast.

The assessment of diagnostic image quality for MRI is considered. The assessment of three key image quality determinants is addressed: signal, noise and contrast. There is a distinction between random noise evaluation, for the calculation of the SNR, and structured noise evaluation for the assessment of image artefacts. Specific methods used are correlation techniques and the Wiener spectrum. Contrast is assessed by comparison of experimental data and theoretical predictions. For each assessment, the theory and method of the evaluation strategy are discussed. The discussion is illustrated with analysis results from commercial MR systems. The choice of analysis method and the subsequent derivation of quality indices are shown to be critical in respect of robustness and accuracy.

The modification of the RF field distribution of surface coils by weakly conducting saline samples.

The modification of the RF field distribution of a surface coil, which is brought about by both loading and skin effect conditions arising from the proximity of weakly conducting saline samples, is demonstrated. A procedure for the calibration of the depth of the spectral acquisition region in depth-pulse localized in vivo spectroscopy is shown to be acceptable.

An evaluation of the effect of fasting on the exercise-induced changes in pH and Pi/PCr from skeletal muscle.

The changes in the response of skeletal muscle to maximal dynamic exercise were investigated in going from a fasted state to a refed state by means of 31P NMR spectroscopy. It was found that in the fasted state, exercise-induced changes in Pi/PCr and in pH were both inhibited, in comparison with those in the refed state.

A proton NMR relaxation evaluation of a model of brain oedema fluid.

Using CSF/protein solutions as models of vasogenic extracellular fluid, the concentration dependences of longitudinal and transverse proton relaxation rates have been measured at 37 degrees C and 100 MHz for the serum proteins, albumin, IgG, a 2.8:1 mixture of albumin and IgG and human serum itself. These measurements have been used to determine the sensitivity of proton relaxation rates to the amount and the type of the protein in oedema fluid, and to establish the significance of both of these factors in relation to a separation of vasogenic from cytotoxic oedema. An extension of the two-environment rapid-exchange model of solvent relaxation is presented, which accounts for the measurements on protein mixtures and which enables estimates to be made of the number and the transverse relaxation rate of water protons associated with the protein surface.

Covalent binding of a fluorinated 2-nitroimidazole to EMT-6 tumors in Balb/C mice: detection by F-19 nuclear magnetic resonance at 2.35 T.

A hexafluorinated 2-nitroimidazole (CCI-103F) has been synthesized and its properties as a hypoxic cell binder investigated. The drug has a plasma half-life of 90 min in Balb/C mice and a tumor-to-plasma ratio of 0.8. Following sustained exposure to the drug and a washout period for the unbound drug, liver and tumor samples were excised. NMR investigation of the excised tissue in a 2.35 T animal sized NMR facility revealed the presence of 19F bound to both tissues. Further improvement in sensitivity is required to make 19F NMR detection of binding in situ feasible.

The influence of oxygenation on the 19F spin-lattice relaxation rates of fluosol-DA.

The spin-lattice relaxation rates (1/T1) were measured at 94.1 MHz for six peaks in the 19F NMR spectrum of the perfluorochemical blood substitute fluosol-DA, which contains a mixed emulsion of perfluorodecalin and perfluorotripropylamine. Each of these rates increased linearly with the percentage of oxygen dissolved in the emulsion. Relative values of the linear increase for different peaks established that, for perfluorotripropylamine in the mixed emulsion, the oxygen-fluorocarbon interaction is loosely but preferentially oriented in a manner similar to that previously established for other pure fluorocarbons. The uncertainty in the oxygen level estimated from T1 measurements is somewhat less than 5% O2 and it is thus established that quantitative non-invasive oxygenation measurements can be made to sufficient precision by this approach, using fluosol-DA and 19F spin-lattice relaxation.