| 1. |
- Paanalahti, Kari, et al.
(författare)
-
Spinal pain—good sleep matters : a secondary analysis of a randomized controlled trial
- 2016
-
Ingår i: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 25:3, s. 760-765
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe estimated prevalence of poor sleep in patients with non-specific chronic low back pain is estimated to 64 % in the adult population. The annual cost for musculoskeletal pain and reported poor sleep is estimated to be billions of dollars annually in the US. The aim of this cohort study with one-year follow-up was to explore the role of impaired sleep with daytime consequence on the prognosis of non-specific neck and/or back pain.MethodsSecondary analysis of a randomized controlled trial, including 409 patients.ResultsPatients with good sleep at baseline were more likely to experience a minimal clinically important difference in pain [OR 2.03 (95 % CI 1.22–3.38)] and disability [OR 1.85 (95 % CI 1.04–3.30)] compared to patients with impaired sleep at one-year follow-up.ConclusionPatients with non-specific neck and/or back pain and self-reported good sleep are more likely to experience a minimal clinically important difference in pain and disability compared to patients with impaired sleep with daytime consequence.
|
|
| 2. |
- Prytz, Erik, 1985-, et al.
(författare)
-
A pilot investigation of the effect of transport-related factors on care quality in a moving ambulance
- 2019
-
Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 34:1, s. 158-158
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction:Providing patient care in a moving ambulance can be difficult due to various transport-related factors, (e.g., accelerations, lateral forces, and noise). Previous research has primarily focused on cardiopulmonary resuscitation (CPR) performance effects but has neglected to investigate other care interventions.Aim:To test a range of different care interventions during different driving scenarios.Methods:A workshop with ambulance practitioners was held to create a list of care interventions to be tested. Two ambulance practitioners were recruited to drive an ambulance on a closed test-track while performing care interventions on simulation models. Three driving scenarios of differing difficulty were used. Main outcome measures were estimates of workload using the NASA Task Load Index (TLX) and task difficulty. G-forces and video-data were also collected.Results:Estimated workload increased overall as the difficulty of the driving scenario increased, as did task difficulty estimates. However, some care scenarios and interventions were affected less. For example, placing intravenous access increased greatly in difficulty, whereas saturation and blood pressure measurements had more modest increases. TLX scores showed that the primarily estimated physical workload and effort that increased, but also mental and temporal demands for some care scenarios. The more difficult driving scenarios primarily increased the variability of measured G-forces but not necessarily the overall driving speed, indicating that force variability is an important factor to study further.Discussion:The study was intended as an initial pilot test of a wide range of care interventions. It will serve as input to future, larger studies of specific interventions and transport-related factors. Overall, this small pilot indicates that more interventions than only CPR should be studied in moving ambulances to investigate potential performance effects. This is important for traffic, patient, and work safety for ambulance workers and patients.
|
|
| 3. |
- Sallinen, Mikael, et al.
(författare)
-
Sleep, alertness and alertness management among commercial airline pilots on short-haul and long-haul flights
- 2016
-
Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 98, s. 320-329
-
Tidskriftsartikel (refereegranskat)abstract
- Airline pilots' sleep and on-duty alertness are important focus areas in commercial aviation. Until now, studies pertaining to this topic have mainly focused on specific characteristics of flights and thus a comprehensive picture of the matter is not well established. In addition, research knowledge of what airline pilots actually do to maintain their alertness while being on duty is scarce. To address these gaps in research knowledge, we conducted a field study on a representative sample of the airline pilots of a medium-sized airline. The sample consisted of 90 pilots, of whom 30 flew long-haul (LH) routes, 30 short-haul (SH) routes, and 30 flew both. A total of 86 pilots completed the measurements that lasted for almost two months per pilot. The measurements resulted in a total of 965 flight duty periods (FDPs) including SH flights and 627 FDPs including LH flights. During the measurement periods, sleep was measured by a diary and actigraphs, on-duty alertness by the Karolinska Sleepiness Scale (KSS) in all flight phases, and on-duty alertness management strategies by the diary. Results showed that SH and LH FDPs covering the whole domicile night (00:00-06:00 at home base) were most consistently associated with reduced sleep-wake ratio and subjective alertness. Approximately every 3rd FDP falling into this category involved a reduced sleep-wake ratio (1:3 or lower) and every 2nd a reduced level of subjective alertness (KSS rating 8-9 in at least one flight phase). The corresponding frequencies for the SH and LH FDPs that partly covered the domicile night were every 10th and every 5th FDP and for the pure non-night FDPs every 30th and every 36th FDP, respectively. The results also showed that the pilots tended to increase the use of effective on-duty alertness management strategies (consuming alertness-promoting products and taking strategic naps) in connection with the FDPs that overlapped the domicile night. Finally, the results showed that the frequency of flights involving reduced subjective alertness depended on how alertness was assessed. If it was assessed solely in the flight phase just before starting the landing procedures (top of descent) the phenomenon was less frequent than if the preceding cruise phase was also taken into account. Our results suggest that FDPs covering the whole domicile night should be prioritised over the other FDPs in fatigue management, regardless of whether an FDP is a short-haul or a long-haul. In addition, the identification of fatigue in flight operations requires one to assess pilots' alertness across all flight phases, not only at ToD. Due to limitations in our data, these conclusions can, however, be generalise to only LH FDPs during which pilots can be expected to be well acclimatised to the local time at their home base and SH night FDPs that include at least 3h of flying in the cruise phase.
|
|
