The increase in hybrid-work or work-from-home demands setting-specific strategies to improve health-promoting behaviors. This study compared the effects of a behavioral intervention based on individualized workplace counseling to an educational approach based on a standardized factsheet. University employees (n = 121) were randomly allocated to three groups receiving: (1) a factsheet visualizing the World Health Organization (WHO) guidelines on physical activity and sedentary behavior, (2) 20 min of individualized counseling tailored to individual barriers, opportunities, and personal strengths, or (3) no advice (control group). Physical activity (minutes per week) and sedentary behavior (minutes per day) during leisure- and occupational time were assessed before and 4 weeks after interventions using the Nordic Physical Activity Questionnaire. Further outcomes were well-being (WHO-5 questionnaire), pain intensity, and pain interference with work (both with the Short Form 36 Health Survey). Descriptive data are indicated as mean and standard deviation, and the effects of the interventions were analyzed using analysis of variance (ANOVA). The participants (age 43.6, 12.2 years, body mass index 24.3, 3.9 kg/m²) showed high levels of leisure-time physical activity (294.30, 215.37 min) and moderate levels of sedentary behavior (504.33, 158.82 min) at baseline. Overall, physical activity levels (32.37, 112.51 min) and especially vigorous intensity levels (3.88, 19.64 min) at work were low. A large share of daily sedentary time was accumulated during work (414.05, 105.19 min). The individualized counseling group decreased workplace sedentary time (-30.73, 81.74 min), compared to the factsheet (0.00, 54.35 min) and control groups (+ 6.00, 72.92 min), and increased workplace vigorous intensity activity (+ 10.24, 43.10 min), compared to the factsheet (+ 0.50, 3.16 min) and control group (-6.75, 28.77 min) (p<.05). No intervention showed any effect on leisure activity levels, well-being or perceived bodily pain (p>.05). An individualized approach to setting-specific physical activity counseling improves health-promoting behaviors in physically active persons with sedentary occupations. Registered at the German Clinical Trial Register: drks.de (registration number: DRKS00031671; 04 Feb 2025). Retrospectively registered.

Background Healthcare staff in primary care settings are increasingly exposed to verbal and physical aggression. Although violence prevention measures are available, implementation remains inconsistent. This study aimed to explore facilitators and barriers to the use of violence prevention strategies, with a particular focus on the roles of staff and leadership in general practice.Methods We conducted a qualitative study involving semi-structured interviews with thirty physicians and medical assistants working in German general practices. The interview guide addressed perceptions of individual roles, leadership support, organisational structures, and existing preventive measures. We analysed the data using qualitative content analysis following Mayring.Results We found that the use of violence prevention strategies is influenced by interrelated individual, organisational, and leadership factors. Key facilitators included strong leadership engagement, clear communication of expectations, structured staff training, and individual competencies such as resilience and prior experience. Major barriers included high workload, staff shortages, limited financial and time resources, and a lack of formalised procedures. Leadership emerged as a central determinant: visible commitment, active involvement, and resource provision by practice leaders enhanced staff adherence and confidence. In contrast, insufficient leadership prioritisation hindered the systematic use of preventive measures.Conclusions Effective violence prevention in general practice requires a multi-level approach integrating individual, organisational, and leadership dimensions. Strengthening leadership engagement, improving resource allocation, developing practical guidelines, and embedding training into routine workflows are important for overcoming existing barriers. Future efforts should prioritise the development of a proactive prevention culture, with leadership playing a pivotal role in enabling and supporting staff in managing patient aggression.Clinical trail number Not applicable.

Abstract Background Occupational activities involving prolonged postures, restricted movements, and wearing heavy protective equipment contribute significantly to work-related musculoskeletal disorders (MSDs) in police officers. Therefore, this study aims to assess the prevalence of MSDs at an organizational unit of a German federal state police force in relation to self-reported causes of MSD. Methods 255 (211 m/44 f) participants within the age from 21 to 57 years (28.29 ± 6.57 years) answered a modified version of the Nordic Musculoskeletal Questionnaire (NMQ) in nine different body areas (cervical spine/neck, thoracic spine, lower back/lumbar spine, shoulder, elbow, hand and wrists, hip, knee, foot and ankles). For statistical analyses descriptive analyses, Spearman’s rank correlation coefficient and the Rasch model analyses were applied. Significance level was set at 5%. Results Of the 255 participants 95.7% engage in physical activity during their leisure time, with the vast majority (78.1%) also involved in occupational sports activities. The overall 12-month prevalence of MSD was 92.9%, while the most affected areas were the lower back (64%), followed by the neck/cervical spine (57.8%), shoulder (48.6%) and the thoracic spine (33%). The 7-day prevalence stands at 56.1%. The regions most commonly affected are similar to the 12-month prevalence: the neck/cervical spine with 25.1%, followed by the lower back (20.4%), the shoulder (13.7%), and the thoracic spine (11.8%). Only 7.1% reported no symptoms at all. 1.6% indicated experiencing discomfort in all body regions. The Rasch-derived musculoskeletal symptom score showed significant positive correlations with age (r = 0.17, p < 0.01), BMI (p < 0.01, rho = 0.19), and years of service (r = 0.20, p < 0.01). Participants most frequently attributed their musculoskeletal complaints to carrying heavy equipment, prolonged sitting, and awkward postures, followed by stress and insufficient recovery. Only a minority associated their symptoms with sports or physical training, suggesting that ergonomic and organizational factors are perceived as the primary contributors to MSDs. Conclusion Musculoskeletal disorders are highly prevalent among German police officers, affecting nearly all participants despite a young mean age and high physical activity levels. The predominance of multi-site pain, particularly in the lower back, neck, and shoulders, highlights the cumulative impact of occupational load rather than isolated risk factors. Equipment-related load carriage, prolonged static postures, and organizational demands appear to be key drivers, while age, BMI, and years of service exert additional but modest influence. These findings underscore the need for early, occupation-specific preventive strategies that integrate ergonomic optimization, task organization, and targeted physical training to preserve work ability and operational readiness over the course of a policing career.

BACKGROUND:Tobacco use remains a leading cause of preventable morbidity and mortality and is commonly initiated in adolescence. We evaluated whether Smokerface-Poster, a low-intensity, appearance-based school campaign promoting a photoaging app, could attenuate smoking uptake among early adolescents. METHODS:In this two-arm cluster-randomized controlled trial, 126 German secondary schools (9797 grade 6/7 students; 96.0% were 11-13 years old; 51.4% male; 48.6% female) were allocated to intervention or control. Intervention schools displayed two classroom posters for 24 months. Smoking behavior was assessed at baseline and 24 months. As primary outcome, we investigated the between‑group difference in the change in 30-day smoking prevalence, with a number needed to treat (NNT) of < 100 students predefined as clinically relevant per protocol. RESULTS:Baseline smoking prevalence was 7.4% in the control vs. 7.9% in the intervention group. At 24 months post-intervention, smoking prevalence increased by 19.2 %age points in control vs. 18.1 %age points in the intervention group (number needed to treat=93; adjusted ratio of odds ratios 0.87, 95% CI 0.69-1.09; p = 0.228). Favorable, non-significant patterns were also observed for anti-smoking intentions and attitudes. CONCLUSION:Although the between-group difference was not statistically significant, the intervention reached the predefined threshold for clinical relevance, with an NNT of 93. This suggests that, for every 93 students exposed to the Smokerface-Poster campaign, one fewer adolescent would be expected to smoke over the two-year follow-up. Given its low cost of < €50 per 100 students, the intervention appears to be a promising approach to supporting school-based smoking prevention.

The existing literature on pre-professional ballet students mostly reports on injury patterns, eating disorders, hormonal paramenters or other singular items whereas an overall description of anthropometric and orthopedic values of this particular study population can rarely be found. The aim of the present article was to anthropometrically and orthopedically describe the lower extremity of the typical vocational ballet student, establish a database and enable future comparisons. In this study, n = 606 students (414 female, 192 male) of a governmental institution for vocational ballet in Germany, between the ages of 5 and 22 (Mean ±SD: 13.9 ±3.5) were examined by an experienced orthopedist and dance physician. The average passive external rotation of the hip (ER) was 60° (±7.5) and 43.5° (±11.3) for the internal rotation (IR). The calculated range of motion (ROM) was 103.3° (±10.4). The mean tibial torsion (TT) was 22.4° (±6.3). The average calculated turnout (ER + TT) was 83.3° (±9.9) per leg. The passive dorsiflexion (DF) of the ankle was 23.6° (±4.7) and 70.1° (±7.5) for plantarflexion (PF). 52.5

Introduction: Dental professionals are susceptible to musculoskeletal disorders due to unphysiological postures during treatment, which can be mitigated by the choice of a work chair to improve ergonomic working posture. Methods: In this study, the influence of five different work chairs on the ergonomic risk assessment using RULA and the working behaviour of 22 right-handed dentists was investigated. To this end, dental treatment was simulated on a phantom head, with the body posture recorded using an inertial motion capture system. The resulting kinematic data were converted into a continuous RULA scheme, and statistical methods (Friedman test with Conover–Iman comparisons and statistical parametric mapping) were used to compare the chairs. The significance level was set at p ≤ 0.05. Results: The RULA analysis revealed no significant differences between the task chairs that were tested; however, it should be noted that all of the task chairs exhibited an increased ergonomic risk (RULA ≥ 5), which indicates an increased risk of musculoskeletal disorders. Significant multiple comparisons (SPM analysis) between the selected chairs of the relative occurrence of total joint angles were between Chair 1 vs. 5 (p ≤ 0.03 for shoulder left flexion–extension), Chair 2 vs. 4 (p ≤ 0.03 for shoulder right flexion–extension), Chair 1 vs. 3 (p ≤ 0.03 for trunk right flexion–extension, 0.04 for trunk lateral flexion and 0.05 for elbow left flexion–extension), Chair 3 vs. 4 (p ≤ 0.05 for shoulder left flexion–extension and 0.01 shoulder right flexion–extension), and between Chair 2 vs. 3 (p ≤ 0.05 for elbow left flexion–extension). Discussion: The study’s findings indicate that the selection of work chairs did not have a significant impact on the ergonomic risk, which remained consistently high across all the chairs. Nevertheless, the analysis of joint angles demonstrated that the Ghopec chair was more frequently associated with greater joint angles, with only a few significant deviations. However, it should be noted that these significant differences in joint angles occurred only sporadically, did not demonstrate a clear and consistent trend across all the chairs, and have no clinical impact. Overall, the results confirm that the working posture of the dentists has a potential risk of developing musculoskeletal disorders, while the ergonomic design of the work chairs plays a rather subordinate role.

Psychological and social health is particularly important for police officers to perform their duties. Therefore, the present study identified and analysed relevant influencing psychosocial factors on officers of a state police unit in Germany. 253 (209 m/44f) police officers from a single, federal state police force in Germany volunteered to answer questionnaires which comprised the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Operational Police Stress Questionnaire (PSQ-Op). In addition, based on the response behaviour to each question, an Item Response Theory (IRT; Rasch model) was applied. This calculated score (Rasch score) can be regarded as a predictor of well-being (COPSOQ) and work-related stress (PSQ-Op) and was correlated with age, body mass index (BMI), weight, height and years/hours of work. The significance level was set at 5

Earlier, interventional and sonography techniques have been analyzed in detail for the field of internal medicine concerning workplace ergonomics. Here, work related musculoskeletal disorders (WRMSDs) have been reported with a prevalence of about 76%. The aim of this study is to provide a comprehensive kinematic and ergonomic analysis of an average working day of a resident physician in internal medicine on a cardiological ward. The kinematic data of 17 resident physicians (9f/8m) of internal medicine, working in 3 different cardiological wards in a hospital of maximum care was collected on an average workday using the CUELA measurement system. A detailed, computer-based task analysis was conducted concurrently with the kinematic assessment. By synchronizing the data obtained from both measurements, postural patterns were chronologically aligned and contextualized with the corresponding task performance. The main categories were (1) Office work, (2) Ward rounds, (3) Tasks performed directly with the patient (i.e. patient examination, blood withdrawal) and (4) Other. The main categories were divided into several sub-categories for further differentiation. For the data analysis, characteristic values of joint angle distributions (percentiles P05, P25, P50, P75, and P95) for the head, neck, and torso during predefined tasks were examined and evaluated in accordance with ergonomic standards. In addition, the Owako Working Posture Analysing System was applied (OWAS). A total duration of 129.2 working hours were recorded. Resident physicians of internal medicine on a cardiological ward spend a large part of their work day in office type work situations (57%) with 36% dedicated to computer work, followed by 18% for ward rounds and 16% for directly patient related activities. The office type work situations showed high sedentary rates with increased ergonomic risk for postures of the cervical and thoracolumbar spine (moderate to unfavorable postures for back curvature in almost all percentiles and office activities, reclination of the neck during (-8°- -16° in P05 and P25) for 'use of computer'. Several aspects of patient related activities displayed high percentages of forward bending (predominately moderate and unfavorable postures for back curvature, sagittal trunk and neck inclination) and in P25-P95 for 'blood withdrawal' and 'patient examination'. An important office type work setting is predominant in the daily routine of resident physicians of internal medicine working on cardiological wards and have been detected as important predictor to cause musculoskeletal stress. Resident physicians of internal medicine on cardiological wards have a high occurrence of ergonomically unfavorable situations, particularly during patient related activities and sedentary work using visual display units. This study highlights the need for ergonomic interventions particularly in respect to adjustable, individualized workstations and equipment.

As Nipah virus (NiV) infection is characterised by a possible pandemic risk, being currently limited to a small but deadly belt, the attention of other countries is essential. It has often been pointed out that NiV is an under-researched virus with a high-risk potential. This study aimed to show the global research history and status quo based on analyses of various chronological and geographical parameters, including socioeconomic characteristics and research funding. For this purpose, advanced analysis methods and visualisation techniques were applied, such as density equalisation mapping and cluster analysis. The correlation between the number of articles on NiV and the economic strength or intensity of financing per country is significant. However, the comparatively low scientific commitment of countries that are usually among the major players in global scientific publications and the declining scientific interest in NiV research combined with the prevailing knowledge gaps in NiV infectiology in conjunction with the risk of NiV spreading to other areas is extremely threatening. Research on previous viruses such as Corona and mpox shows an equally short-term interest, which has led to an insufficiently prepared situation in the run-up to outbreaks, making it hard to find quick and effective solutions. As often said, the NiV infection belt is small but deadly, but global travel and trade increase the risk of spreading. The scientific community worldwide must be prepared for the possible spread of infections that pose a pandemic risk.

Background: Digitalisation is becoming increasingly integrated into the field of dentistry; therefore, it is crucial to understand both the challenges it introduces and the opportunities it provides. By doing so, the research will offer insights into how digital tools can affect the work environment and contribute to the overall well-being and performance of dental professionals. Objectives: The present study aims to explore how dentists perceive the demands and resources within a digitalised dental practice. Methods: The present study adopted a qualitative design, incorporating guideline-based interviews. A total of 30 interviews were conducted with dentists from various German dental practices, with a focus on key topics such as job demands, job resources, digital stress factors, job satisfaction, and support needs in the context of digital dentistry. The interview data were analysed using qualitative content analysis. Results: The findings highlight that digital systems in dental practices offer benefits such as reduced errors and time savings, but also pose challenges, especially for less experienced users. While they improve efficiency, precision, and professional development, they can also lead to negative effects like dependence on technology, loss of manual skills, technical failures, and increased stress, particularly during the adaptation phase. These results suggest that successful integration of digital technologies requires adequate support to overcome initial learning curves and ensure long-term benefits. Conclusions: The results of the study underline the importance of effective implementation, comprehensive staff training, and technological reliability to maximise the benefits of digital tools and minimise their drawbacks. Maintaining a balance between digital stressors and resources is crucial to promoting a healthy work environment. Future research should focus on the long-term effects of training programmes and the integration of digital technologies into dental practices to increase their effectiveness in terms of job satisfaction and reduce potential risks.

Background: The utilization of digital technologies in the field of dentistry is becoming increasingly prevalent. Such technologies facilitate more precise and efficient dental treatment while also enhancing the overall quality of care. The advent of digitalization has brought with it a plethora of advantages, yet it has also given rise to a number of potential challenges. These have the potential to give rise to a variety of negative consequences, including an increase in stress perception. Objectives: This study identifies the digital demands and resources as well as the prevalence of digital stress perception among German dentists. Furthermore, the study examines the relationship between digital stress perception and work- and health-related outcomes, and it identifies potential preventive measures. Methods: The quantitative cross-sectional study involved a total of 325 German dentists. Data collection took place between January and April 2024. The questionnaire was validated using several established scales, including the Technostress Scale and the Copenhagen Psychosocial Questionnaire (COPSOQ). Multiple correlation and regression analyses were conducted to ascertain the reliability and validity of the data collected. Results: The study results demonstrated that the participating dentists exhibited a moderate level of digital stress (M = 3.73 (SD = 0.71). Regarding the individual technostress creators, the highest mean was observed for the constructs of techno-overload (M = 3.91; SD = 0.76), techno-complexity (M = 3.63; SD = 0.71), and techno-uncertainty (M = 2.01; SD = 0.75). The participants reported an average level of exhaustion symptoms (M = 3.21; SD = 0.91) and job satisfaction (M = 4.52; SD = 0.78). The association between technostress and emotional exhaustion (as a burnout symptom) showed a significant positive correlation (r = 0.38; CI: 0.07, 0.52; p < 0.05). A significant negative correlation was observed between the variables of technostress and job satisfaction, with a correlation coefficient of r = −0.33 (CI: −0.25, 0.07; p < 0.05). Conclusions: This study presents preliminary findings on the digital stress experience in dentistry and relevant associations. In the context of ongoing digitalization, there is a need for support and preventive measures to reduce technology-related stress. An optimized design of digital applications and the working environment are of crucial importance to improve the health of dentists and the quality of patient care.

Die Förderung der Gesundheit am Arbeitsplatz ist ein wesentlicher Faktor für die nachhaltige Sicherung der Beschäftigungsfähigkeit. Allerdings zeigt sich, dass Menschen mit Behinderungen im Vergleich zu nichtbehinderten Menschen einen deutlich höheren Krankenstand aufweisen. Dies stellt Unternehmen vor die Herausforderung, mit finanziellen Belastungen umzugehen. Seit dem 1. Januar 2018 sieht das Gesetz (§§ 215–218 SGB IX) vor, dass Inklusionsbetriebe Maßnahmen der betrieblichen Gesundheitsförderung umsetzen. In dieser narrativen Übersichtsarbeit werden die vorhandenen Forschungsergebnisse zu evidenzbasierten Programmen zur betrieblichen Gesundheitsförderung, die auf Inklusionsunternehmen zugeschnitten sind, sowie aktuelle Empfehlungen zur Förderung nachhaltiger Gesundheitsverbesserungen bei den Beschäftigten in solchen Einrichtungen dargestellt. Die Analyse stützt sich auf eine umfassende Literaturrecherche in englischen und deutschen Datenbanken, darunter PubMed/MEDLINE, Cochrane und Google Scholar. Zur Erreichung der sozialen Zielsetzungen von Inklusionsbetrieben ist es entscheidend, gesundheitsförderliche Rahmenbedingungen zu schaffen, die auf die individuellen Bedürfnisse aller Beschäftigten – unabhängig von einer Behinderung – abgestimmt sind. Allerdings sind evidenzbasierte Programme zur betrieblichen Gesundheitsförderung, die sowohl Mitarbeitende mit als auch ohne Behinderung einbeziehen, bislang kaum verbreitet. Da die Forschungslage zu solchen Projekten noch relativ begrenzt ist, sollte diese weiter ausgebaut werden, um eine fundierte Bewertung der verschiedenen Maßnahmen zu ermöglichen. Allerdings gibt es mittlerweile einige Empfehlungen, die eine nachhaltige Verbesserung der Gesundheit von Mitarbeitenden in Inklusionsbetrieben unterstützen können.

BACKGROUND:Artificial intelligence (AI) will have a lasting and drastic impact on medical research and healthcare. In addition to the benefits, the associated risks are also the subject of controversial debate and there are fears of serious consequences. There is an urgent need for action, which must be underpinned by scientific information. METHODS:By analyzing temporal and geographic patterns, including national readiness for access to AI, we therefore identified incentives and barriers to global research under socioeconomic conditions. RESULTS:The explosive increase in annual publications started in 2017. The main players in AImed research were the USA, China, the UK, Germany, and South Korea. There was a significant correlation between the publication output on AI in medicine (AImed) and the metrics for economy and innovation. Additionally, citation patterns show the disadvantage of the Global South compared to the North American and European countries. In several weaker economies: Jordan, Pakistan, Egypt, Bangladesh, and Ethiopia, a more positive position was found in relation to the number of articles suggesting a better ranking in AImed research in the future. CONCLUSION:The results show the need for advanced global networking to ensure all relevant aspects for equitable development and the beneficial use of AImed without promoting racial or regional inequities and to enforce this not only in the AI systems of economically strong countries but also for the participation of economically weaker countries.

Particulate matter pollution poses a growing health risk, especially during physical activity and active commuting in traffic-heavy urban areas. This study compared the concentration of particulate matter on the same urban road either open or closed to motorized traffic. Particulate matter (PM1, PM2.5, PM10) was assessed using a bicycle-mounted Mini Laser Aerosol Spectrometer. Data were collected on a 900-m inner-city street in Frankfurt am Main, Germany, on 20 days (10 days with and 10 days without motorized traffic). Meteorological data and local urban background concentrations of PM2.5 and PM10 were taken from three nearby located air quality monitoring stations. The impact of motorized traffic and environmental cofactors on particulate matter exposure (absolute values for PM1, normalised to local urban background concentrations for PM2.5 and PM10) were analysed using linear mixed models. When the cycled road was closed for motorized traffic, mean and standard deviation values of 6.9 +/- 4.8 mu g/m3 PM1, 9.8 +/- 5.3 mu g/m3 PM2.5, and 19.2 +/- 10.1 mu g/m3 PM10 occurred. Compared to the car-free condition, the presence of motorized traffic was associated with significantly higher particulate matter concentrations, with an average increase of 3.2 mu g/m3 (95 % CI: 3.0, 3.5) for PM1, 1.3 mu g/m3 (95 % CI: 0.9, 1.7) for PM2.5 and 3.4 mu g/m3 (95 % CI: 2.4, 4.4) for PM10. As an additional finding, higher air pressure, humidity and temperature as well as lower wind speeds were linked to increased particulate matter concentrations. Concepts like open streets or car-free days which include temporary or permanent road closures to motorized traffic have health-promoting potential by drastically reducing the local particulate matter exposures for pedestrians and cyclists.

Endocrine disruptors (EDs) contaminate nearly every ecosystem and are significantly associated with different neurological and neurodevelopmental disorders. To date, there is no comprehensive literature on global publication efforts. Since there are many unknown substances, modes of action, and risks of EDs, it is necessary to provide detailed insight into global publication patterns from temporal, regional, and socioeconomic perspectives. Hence, this review article provides background information for all stakeholders, from scientists to clinicians and policymakers. A disproportionate increase in research activity was observed, mainly from the USA and China, with a strong north-south divide. Multi-disciplinarity is characteristic, with a trend toward an ecological focus. Low- and middle-income economies are underrepresented in research on EDs. Therefore, global research needs to be refocused and expanded to more global approaches that take inspiration from the few successful collaborations with their synergistic effects.

Late-stage rehabilitation interventions after an anterior cruciate ligament (ACL) reconstruction are under-researched, inter alia regarding potential differences in rehabilitation effects between autograft types. This study determined the effectiveness of a specific, late-stage rehabilitation to usual care after ACL reconstructions in patients with a quadriceps versus such with a hamstring tendon autograft. In this multicentre case-control intervention study, participants aged 18-35 years were included at the end of their formal rehabilitation (mean 8.1 months) after ACL reconstruction. Twenty-four cases with an arthroscopically assisted, anatomic ipsilateral quadriceps femoris tendon autograft and two numerically equal hamstring tendon reconstructed propensity score-matched groups were compared. Matching variables were gender, age, Tegner activity scale, plus, once, the time since reconstruction and once the functional capacity at intervention onset. All participants performed a 5-month performance enhancing intervention. All outcomes were measured once a month. Self-reported outcomes such as knee function (The Knee injury and Osteoarthritis Outcome Score (KOOS) Sport as the main self-reported outcome) were followed by a series of hop and jump tests. The front hops for distance (outcome: hopping distance) was the primary outcomes of the study. Linear mixed models were calculated using change scores. All participants were analysed. No group*time interaction effect could be identified in the two main outcomes KOOS SPORT and front hop for distance. Furthermore, with the exception of the self-reported all-day function, no outcome displayed any between-group differences in the trainability, either. The return-to-sport success took a mean time of 3.8 months after study commencement; the success rates ranged between 80% and 83% and were not different between groups. Being reconstructed with a hamstrings or with a quadriceps tendon autograft had no impact on the late-stage rehabilitation effects after an ACL rupture. Both graft choices enable comparably favourable functional outcomes and return-to-sport success rates. Conversely, no recommendation can be derived with regard to the selection of either a hamstring or a quadriceps autograft type. The decision must be undertaken individually and based on other factors.

OBJECTIVES:To find contributors to return to sport success or time until return to sport in individuals after an anterior cruciate ligament reconstruction. DESIGN:Cohort study. METHODS:Secondary analysis of the data of two intervention studies. PARTICIPANTS:We included adults < 36 years of age with a tendon autograft anterior cruciate ligament reconstruction who were active in any type of sport prior to the injury and aiming to return to sport. All participants were prospectively monitored for 24 months. INTERVENTIONS:At the end of the individual post-surgery rehabilitation and re-injury prevention programmes, self-report- and objective functional outcomes were quantified. MAIN OUTCOME MEASURES:The potential return to sport success (return to the same type of sports, frequency, intensity, and quality of performance as pre-injury), secondary injuries, and all rehabilitation and training measures were prospectively monitored. To determine the contributing factors, Cox regressions for traits and baseline factors and a logistic mixed model, which also included prospective time-dependent factors, were calculated. RESULTS:203 participants were included; 104 (51 % of the total sample and 68 % of the full cases) successfully returned to their sporting activity. The median duration until return to sport was 302 days (interquartile range was 114 days). Contributing factors were the type of working (blue- vs. white collar: odds ratio for return to sport = 0.51 [95 % confidence interval = 0.29 to 0.90]) and the athletic status (elite vs. non-elite: odds ratio = 2.28 [1.03 to 5.03]). Prospectively, higher rehabilitation volumes until the end of the rehabilitation were predictive for return to sport success: the odds ratio per additional hour of rehabilitation was 1.004 [1.001 to 1.006]. Functional abilities such as the normalised knee separation distance during drop jump landing (odds ratio = 0.961 [0.924 to 0.999]) were predictive at a later stage, at the end of the re-injury prevention. Psychological readiness for return to sport was predictive at most of the timepoints: those who were confident to return to sport were more successful to return to sport at the end of the rehabilitation (odds ratio = 1.029 [1.004 to 1.056]) and at the end of the re-injury prevention (odds ratio = 1.038 [1.004 to 1.073]). CONCLUSIONS:The most important factors for a successful pre-injury-level return to sport after anterior cruciate ligament reconstruction were the exercise volume, psychological readiness and functional hop/jump abilities. Whilst the impact of these modifiable factors was robust against multilevel modelling, the impact of athletic and working status vanishes when the prospective factors are included.

A substantial body of research has documented a high prevalence of neck, shoulder, wrist, and back pain among sonography users. However, the specific postures that contribute to these complaints have scarcely been systematically investigated, to date. This proposed study offers a novel method to record users’ body posture during sonography examinations kinematically and to survey the complaints of sonography users in various specialities. Using this data, well-founded ergonomic recommendations for the prevention of work-related musculoskeletal disorders (WRMSDs) will be developed. A minimum of 38 study participants across two groups (19 beginners; 19 experienced) per speciality (head and neck sonography, abdominal sonography, cardiac sonography, musculoskeletal sonography, and obstetric/gynaecological sonography) will be assessed using kinematic whole-body (including finger movements) analysis based on inertial motion capture. Subsequently, ergonomic risk will be determined by integrating the quantitative data into the Rapid Upper Limb Assessment (RULA). Moreover, a questionnaire on musculoskeletal complaints and ergonomics in sonography will be used in certified sonography courses, ultrasound-based centres, and university teaching. The primary outcome measures of this proposed study include typical tasks based on joint angles and assessment using RULA scores. In addition, the prevalence of WRMSDs will be recorded. The Mann-Whitney-U test will be employed to calculate the differences between the two study groups in each speciality. In addition, inferential statistical comparisons will be conducted for continuous data using confidence bands; the statistical parametric mapping method will be employed here. The significance level will be set at p = 0.05. This article proposes a study (or series of studies) to describe the continuous ergonomic risk for typical tasks across different disciplines of sonography and to identify increased ergonomic risks. Such studies offer significant potential for preventing WRMSDs. The insights gained could inform the future design of prevention programmes and the development of recommendations for action, as well as teaching sonography users an ergonomically optimised way of working. The results could suggest that ergonomics training is incorporated more thoroughly into ultrasound training curricula to minimise health risks for future users.

Digital technologies are increasingly being integrated into healthcare settings, including the ambulatory sector of general practitioners, with potential improvement in everyday work life. Although the changes sound very promising, the adoption of new technologies can also introduce additional stressors for medical staff, potentially resulting in negative impacts on work performance and health. This study seeks to identify the stressors and resources associated with digitization among general practitioners in Germany, explore their effects on work and health variables, and uncover potential preventive measures to mitigate these stressors. This mixed methods study combined quantitative and qualitative approaches. An online questionnaire was used to examine the relationships between technostress creators, inhibitors, and the perception of technostress, as well as the measures of burnout, job satisfaction, and general health among 114 general practitioners in Germany's ambulatory care setting. The study was carried out between March and June 2024. Several validated instruments were employed, including the Technostress Model and selected items from the Copenhagen Psychosocial Questionnaire (COPSOQ III). Exploratory assumptions were evaluated using descriptive statistics and multiple regression analyses. The study found medium levels of technostress perception among the participating general practitioners (n = 114) along with a substantial level of technostress inhibitors. The general practitioners surveyed in this study reported experiencing burnout symptoms occasionally, expressed a moderate level of job satisfaction, and generally described their health status as good. The relationships between stressors and work- and health-related outcomes were analyzed. This study offers a preliminary overview of the persistence of techno-stressors, technostress inhibitors, and technostress levels and their impact on health- and work-related outcomes among general practitioners in Germany. The findings indicate that using information and communication technologies can lead to heightened stress, increased burnout symptoms, and reduced job satisfaction. As the workload for general practitioners is expected to grow in the upcoming years, the study highlights the critical need for additional preventive strategies to mitigate stress and improve well-being among general practitioners.

Lower limb injuries are common in team sports, often occurring during athletic tasks with high cognitive demands, such as time-constrained decision-making. This systematic review and meta-analysis used robust variance estimation to compare ankle biomechanics during unplanned (time-constrained) versus pre-planned (no decision-making) tasks. Standardized mean differences (SMD) and 95% confidence intervals were pooled to assess differences in ankle kinematics and kinetics. A literature search was conducted in PubMed, Google Scholar, Cochrane Library, and ScienceDirect (until April 2025). Trials assessing ankle kinematics and/or kinetics during pre-planned and unplanned jump-landing or cutting tasks in healthy athletes were included. The GRADE approach was used to rate the certainty of evidence for each outcome as low, moderate, or high. Fifteen trials (162 men, 152 women) with fair to high methodological quality (modified Downs and Black checklist) were identified. In the sagittal plane, low to moderate certainty evidence indicated higher ankle plantarflexion angles during unplanned movement (SMD = 0.27, p = .017). Subgroup analyses showed this effect was most evident in run-and-cut tasks, at initial ground contact, and among elite athletes (SMD = 0.24 to 0.36, p = .017 to .045). Sensitivity analysis excluding outliers indicated low-certainty evidence of increased ankle dorsiflexion angles during unplanned tasks (SMD = 0.25, p = .044), predominantly during the stance phase. Unplanned sports movements may increase ankle plantar- and dorsiflexion, but their impact on injury risk remains uncertain, as these changes may also reflect performance or protective adaptations. Due to the limited number of studies, low certainty of the available evidence, small effect sizes in the sagittal plane, and limited findings in the frontal and transverse planes, further research is warranted to draw more specific conclusions. PROSPERO registration number: CRD42024598492 (date of registration: 18 October 2024)