David M. Antle

First steps for integrating sex and gender considerations into basic experimental biomedical research

In recent decades there has been an increasing recognition of the need to account for sex and gender in biology and medicine, in order to develop a more comprehensive understanding of biological phenomena and to address gaps in medical knowledge that have arisen due to a generally masculine bias in research. We have noted that as basic experimental biomedical researchers, we face unique challenges to the incorporation of sex and gender in our work, and that these have remained largely unarticulated, misunderstood, and unaddressed in the literature. Here, we describe some of the specific challenges to the incorporation of sex and gender considerations in research involving cell cultures and laboratory animals. In our view, the main‐streaming of sex and gender considerations in basic biomedical research depends on an approach that will allow scientists to address these issues in ways that do not undermine our ability to pursue our fundamental scientific interests. To that end, we suggest a number of strategies that allow basic experimental researchers to feasibly and meaningfully take sex and gender into account in their work.—Ritz, S.A., Antle, D. M., Côté, J., Deroy, K., Fraleigh, N., Messing, K., Parent, L., St‐Pierre, J., Vaillancourt, C., Mergler, D. First steps for integrating sex and gender considerations into basic experimental biomedical research. FASEB J. 28, 4–13 (2014). www.fasebj.org

Relationships between lower limb and trunk discomfort and vascular, muscular and kinetic outcomes during stationary standing work

Standing work is associated with discomfort and symptoms in the trunk and lower limb. However, mechanisms underlying these observations are poorly understood. Moreover, most research on standing-related symptoms has focused on only one region (lower limb or trunk), and has not considered the impact and interactions between vascular, muscular and balance outcomes. We measured foot and soleus blood flow, ankle mean arterial pressure, muscle activity of the plantar and dorsi flexors, gluteus medius and trunk flexors and extensors, center of pressure changes and leg and back discomfort in 18 healthy volunteers performing a repetitive box-folding task for 34 min. Results show significant decreases with time in lower limb muscle activity (p<0.00053), and increases in foot blood flow and center-of-pressure mediolateral sway amplitude (p=0.00066). There were significant time effects on back (p=0.017) and lower limb (p<0.000001) discomfort, the latter significantly correlated (r=0.35) to time-related increases in foot blood volume. No changes were correlated to the increase in back discomfort. Results suggest that the origin of standing-related lower limb discomfort is likely vascular in origin, whereas back discomfort is likely multifactorial, involving muscular, vascular and postural control variables.

Occupational interventions for the prevention of back pain: Overview of systematic reviews

INTRODUCTION We conducted an overview of systematic reviews of interventions for the prevention of low back pain (LBP) that can be conducted in a workplace setting. METHODS An electronic literature search was performed in Medline, EMBASE, and the Cochrane Library. Published peer-reviewed systematic reviews and meta-analyses, which described interventions for the primary or secondary prevention of LBP applicable to a workplace setting, were eligible for inclusion. The methodological quality of the included systematic reviews was assessed with the AMSTAR tool. The primary outcome of interest was the incidence of LBP; secondary outcomes were LBP-associated absenteeism, activity interference, and costs related to LBP. RESULTS Twenty-eight eligible articles published between 1994 and 2016 were included in a qualitative synthesis following our screening of abstracts and full-text articles. The AMSTAR rating revealed 14 reviews of high, 10 of moderate, and 4 of low methodological quality. The identified interventions included workplace modifications (6 reviews, 10 studies, 6,751 subjects); shoe insoles (4 reviews, 6 studies, 2,356 subjects); and lumbar supports and other assistive devices (15 reviews, 18 studies, 60,678 subjects). Educational interventions investigated were back schools (10 reviews, 30 studies, 9,973 subjects); manual material handling techniques/advice (6 reviews, 24 studies, 10,505 subjects); and other forms of instruction including pamphlets, booklets, and other media (four reviews, 14 studies, 11,991 subjects). Exercise interventions, investigated in 12 reviews (35 studies, 19,330 subjects), showed moderate quality evidence of effectiveness for exercise interventions alone or in conjunction with educational interventions; no other type of intervention was consistently effective in the prevention of LBP or LBP-associated outcomes of interest. CONCLUSIONS Our overview provides evidence of effectiveness for exercise with or without educational interventions in the prevention of LBP. PRACTICAL APPLICATIONS Exercise interventions with or without educational interventions that can be applied in the workplace have the potential to prevent LBP.

A case study detailing key considerations for implementing a telehealth approach to office ergonomics.

Telehealth approaches to delivering ergonomics assessment hold great potential to improve service delivery in rural and remote settings. This case study describes a telehealth-based ergonomics service delivery process, and compares in-person and telehealth-based ergonomics approaches at an Alberta-based non-profit advocacy group. This project demonstrates that telehealth approaches to ergonomics do not lead to significantly different scoring outcomes for assessment of ergonomics issues, when compared to in-person assessments. This project also outlines the importance of live real-time video conferencing to improving communication, attaining key assessment information, and demonstrating ergonomic adjustments. However, some key considerations of bandwidth and hardware capabilities need to be taken into account. Key communication strategies are outlined to improve rapport, maintain employee confidentiality, and reduce client anxiety around telehealth ergonomics assessments. This project provides further support for telehealth approaches to office ergonomics, and outlines some key implementation strategies and barriers that should be considered.