flexible working scholar

You may switch to Article in classic view. GL, Borrell C, The Effectiveness of Flexible Working Arrangement: Hybridisation of Human Resource Management and Management Accounting Alternate title: Keberkesanan Pengaturan Kerja Fleksibel: Penghibridan Pengurusan Sumber Manusia dan Pengurusan Perakaunan Ten controlled before and after studies, involving 16,603 participants were included. OrthGom!er K, Leppnen A, Kristensen TS, Flexible Our mobile, short, animated videos enable a Working Scholar to complete their degree in a way that fits their lifestyle. the display of certain parts of an article in other eReaders. Our mobile, short, animated videos enable a Working Scholar to complete their degree in a way that fits their lifestyle. Flexible working conditions are increasingly popular in developed countries but the effects on employee health and wellbeing are largely unknown. Vahtera J, We did not exclude documents on the basis of language, country or publication date. this can mean working fewer days per week. Knottnerus JA. Closing the gap in a generation: health equity through action on the social determinants of health, Final Report of the Commission on Social Determinants of Health. In total, 214 publications (185 from the electronic databases and 29 from additional searches) relating to flexible working were retrieved for full paper analysis (see Figure 1). The inclusion criteria were: (i) randomised controlled trial, interrupted time series or controlled before and after study; (ii) physical, mental or general health/ill health measured using a validated instrument; and (iii) length of follow up six months or greater. Smith L, Is there protection against contamination between the intervention and control groups? This continued flexibility appears to be the "new normal" of how we work (Weideman & Hofmeyr, 2020). In some instances it was difficult to assess whether flexibility was defined by the employer or employee. The studies of workerorientated flexibility (specifically selfscheduling of shifts and gradual/partial retirement) reported statistically significant improvements in health outcomeswhen comparing experimental and control groups before and after the intervention. The authors examined the mental health outcome depression using a validated instrument (Diener 1999; Frey 2002; Perreira 2005; Veenhoven 1991) with a maximum followup period of 12 years. Viitasalo 2008 considered the effects of flexibility of shift scheduling in a study conducted in a line maintenance unit of a Finnish airline company. The number of key experts contacted snowballed, as contact with one author signposted the need for communication with additional experts in the field. Wright K, In summary, the literature suggests that employeenegotiated flexible working interventions are expected to have more positive effects on health and wellbeing than employerorientated interventions. Calvo 2009 found that having control over retirement had a significant effect on depression scores (coefficient 0.470, P < 0.01) when comparing those retirees with control and those without control. Vinet A, Similarly, none of the studies included adequate information on the presence or absence of employee, union or managerial support for the intervention and whether or not those implementing the intervention had appropriate experience and access to the necessary resources to deliver the intervention effectively. Flexible and Compressed Work Week schedules: a metaanalysis of their effects on workrelated criteria. Flexibility is the umbrella term used to describe any role that breaks the traditional norm of a rigid 9-to-5, five-day week structure. Six CBA studies reported on interventions relating to temporal flexibility:selfscheduling of shift work (n = 4), flexitime (n = 1) and overtime (n = 1). knn@nrcwe.dk. Though social distancing and other coronavirus related mandates have begun to subside, some employers are continuing to allow their employees flexibility in their work arrangements. Department for Business Enterprise and Regulatory Reform. Contact with experts in the field highlighted an additional two ongoing studies (Garde 20082011; NabeNielsen 20062010) which are listed in the Characteristics of ongoing studies table but are not data extracted or appraised. Similarly, a related systematic review has shown that Compressed Working Week interventions (an alternative work schedule in which the hours worked per day are increased, whilst the days worked are decreased in order to work the standard number of weekly hours in less than five days (Ronen 1981)) can improve worklife balance, and that they may do so with a low risk of adverse health or organisational effects (Bambra 2008b). Nair A, For example, shift work tends to be more common in manual occupations and workers employed in the manufacturing and healthcare sectors (McOrmond 2004; Siegrist 2009). In relation to secondary outcomes, only four of the included studies examined any of the following secondary outcomes: sickness absence, health service usage, health/lifestyle behavioural effects, worklife balance, health and wellbeing of children, family members and coworkers. Equally for women, after undertaking overtime work the odds of becoming a need for recovery case or a psychological distress case were also nonsignificant: OR 1.47 (95% CI 0.64 to 3.38) and OR 0.81 (95% CI 0.40 to 1.62) respectively. Cohen PD, Flexible work refers to the ability to adapt employee contracts with the organization to allow greater adjustability to changing circumstances (Wright and Bretthauer, 2010 ). Were the arrangements likely to benefit the employer or the worker? Also, we have no information on past exposures, for example although participants state that they were not working overtime at baseline we cannot ascertain whether they had recently worked overtime from the data collected. Earlier reviews in this area identified considerable heterogeneity in terms of populations, outcomes and study designs (Bambra 2008a; Bambra 2008b). 18 studies identified as potentially relevant. Both Calvo 2009 and de Vaus 2007 found that control over retirement was related to better health outcomes. It is well recognised that interventions which increase workers autonomy or decision latitude and lead to greater alignment between employee needs and the work environment are likely to increase job satisfaction (Baltes 1999), reduce stress and the likelihood of stressrelated morbidity and ultimately lead to improvements in workers health (Bosma 1997; Kuper 2003; Marmot 2006). tiredness and sleep quality) measures. Future reviews could extend this focus to consider the organisational or economic effects of these interventions by considering outcomes such as staff turnover, worker performance, job satisfaction and employee morale. The reasons for excluding studies which appeared to fulfil the eligibility criteria but were excluded after full paper analysis are listed in the Characteristics of excluded studies table. 45 functional limitations profile.ti,ab. For example, gradual or partial retirement relates to contractual flexibility whereas flexitime might be contractual but implicitly it offers choice and control regarding hours worked. Recent UK research by Capability Jane reveals the demand for flexible working is substantial: However, fewer than 10% of UK advertised jobs currently offer flexibility; the gap between supply and demand is huge. . Having previously looked at the benefits for employees at HSBCand Moneysupermarket Group,here I consider the benefits for business in embracing the change. Employment conditions and health inequalities, Final Report to the WHO Commission on Social Determinants of Health (CSDH), Community studies reporting association between selfrated health and mortality. Young people tend to accumulate negative flexibility outcomes in that they have more limited contractual security, and a greater risk of working on non-standard contracts and of losing their jobs . Difficulty collaborating - The report also states that 48% of UK respondents find hybrid working detrimental to communication. Spelten E. Does individual choice determine shift system acceptability, Intervention in shift scheduling and changes in biomarkers of heart disease in hospital wards, Scandinavian Journal of Work, Environment & Health, Workfamily conflict: the importance of familyfriendly employment practices and familysupportive supervisors. Mental stress, tiredness, mental strain (Standard Shiftwork Index, A significant decrease in tiredness (defined as rather or very tired) during night shift (from 53% to 44%) was noted, time x group interaction P = 0.02. Decreases in systolic blood pressure are known to be associated with a reduction in the risk of stroke and ischaemic heart disease. We identified only a small number of studies for each flexible working intervention and few studies used the same primary and secondary outcome measures. The primary outcome measures included physical health/ill health, mental health/ill health and general health/ill health indicators measured using validated instruments (some possible examples are listed in Table 1). The environmental impact will also be front of mind as travel by cars and planes will be frowned upon. 51 ((facilitat$ or enable$1 or enabling or barrier$1 or obstruct$ or encourag$ or prevent$ or time or free or disrupt$ or relationship$ or conflict) adj2 (cooking or cleaning)).ti,ab. For individuals in the gradual retirement group, mean depression score was 0.120 (SD 0.326) before and 0.165 (SD 0.371) after the transition. There were no significant differences between gradual and abrupt retirees in the following mental health outcomes: levels of positive affect (Beta coefficient 0.04 at 12 months, 0.03 at 36 months), negative affect (Beta coefficient 0.02 at 12 months, 0.02 at 36 months) and selfimage (Beta coefficient 0.02 at 12 months, 0.03 at 36 months. Smith L, A range of physical and mental health outcomes, as well as worklife balance, were measured using validated instruments including the General Health Questionnaire (GHQ12, Goldberg 1972) and the Standard Shiftwork Index (Barton 1992). Cultural expectations and gender role, Abstract This paper examines the impact of the use of worknonwork supports on well-being. Petticrew M, Thomas S, A considerable body of evidence from the Whitehall studies supports the influence of the psychosocial work environment on health (see Bosma 1997; Kuper 2003; Marmot 1991). With Flexibility. Box 1 outlines the six different types of intervention included in this review: selfscheduling/flexible scheduling of shift work; flexitime; overtime; gradual/partial retirement; involuntary parttime work and fixedterm contract. Spelton E, Must possess knowledge of the local area, good organizational, communication and computer skills along with a strong work ethic. full paper, conference proceeding, unpublished report), Is the study a prospective cohort with control? Critics of the Karasek model have prioritised certain aspects of the model, for example by arguing that control may be more important than psychological demands (Godin 2003; Siegrist 2004) and others have drawn attention to mediating factors such as mastery, selfefficacy or social support in the pathway between psychosocial work factors and physical or psychological morbidity (Marmot 2006). We identified a further three papers through citation follow up (de Vaus 2007; Dooley 2000; Smith 1998). Kandolin 1996 reported significant reductions in tiredness during the night shift when comparing intervention and control group participants, although it should be noted that this study reported on the effects of multiple interventions. The findings of this review should, therefore, be interpreted with caution with the caveat that the studies were retrieved using the search strategy presented in Appendix 1 and by applying the inclusion criteria defined in the Methods section. The evidence in this review suggests that interventions which increase employee control by offering workerorientated flexibility (specifically selfscheduling and partial/gradual retirement) are likely to be associated with health improvements including improvements in physical health (reduced systolic blood pressure and heart rate), mental health (e.g. Ropponen T. Occupational stress questionnaire: user's instructions, Finnish Institute of Occupational Health, Reviews 19, Helsinki, A scoring system for subjective health complaints. Working with low rewards is thought to induce stress responses which lead to adverse health outcomes (Siegrist 2009). Shulkin S, Task Group 8 Report to the Strategic Review of Health Inequalities in England post2010 (Marmot Review), Available at: http://www.ucl.ac.uk/gheg/marmotreview/Documents, Real world reviews: a beginner's guide to undertaking systematic reviews of public health policy interventions, Health inequality: an introduction to theories, concepts and methods. Flexible work schedules are being implemented by organizations in certain sectors as either or both a prized employee benefit to promote employee retention and as a device to curb forms of employee withdrawal, such as absenteeism, tardiness, quits and on-thejob leisure. (Y/N/Unclear), Are outcomes reported for a period 6 months or greater? For example, high psychological job demands combined with low control or decision latitude (a combination known as high job strain) in the workplace have been associated with adverse outcomes relating to risk of coronary heart disease (Bosma 1997), mental health (Stansfeld 1999) and sickness absence (North 1996). Reading S, With Flexibility. Albertsen K, Carmichael JC, We are grateful also to our review advisory group members: Professor Antony Lamontagne, Professor Martin White, Professor Carolyn Summerbell, Dr Else Nygaard and Dr Dheeraj Bansal for their insightful comments on the protocol and review. Table 2: Examples of secondary outcomes measured. Blanchard VL, DeebSossa N, This includes part-time working, term-time only working, job sharing and temporary reduction of hours. Dunn Bonferroni statistics for psychological stress: pretest and first posttest: 0.757, pretest and second posttest: 0.778, second and first posttest: 0.099). In the instance that it was not possible to complete these criteria no motivation given was reported on the data extraction form. 20 exp ATYPICAL DEPRESSION/ OR exp "DEPRESSION (EMOTION)"/ OR exp MAJOR DEPRESSION/ OR exp RECURRENT DEPRESSION/, 29 (musculoskeletal adj2 disorder$).ti,ab, 30 ((musculo adj2 skeletal adj2 disorder$)).ti,ab, 32 (promot$ OR manag$ OR facilitat$ OR enable$1 OR enabling OR barrier$1 OR increas$ OR obstruct$ OR encourag$ OR prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict).ti,ab, 33 (health OR healthy OR healthier).ti,ab, 35 ((mental health OR physical health OR health risk$ OR general health)).ti,ab, 44 (GP OR hospital OR doctor OR gps).ti,ab, 45 (consultation$1 OR appointment$1).ti,ab, 49 "general health questionnaire".ti,ab, 53 ((obesity OR obese OR overweight)).ti,ab, 55 "functional limitations profile".ti,ab, 71 59 OR 60 OR 61 OR 62 OR 63 OR 64 OR 65 OR 66 OR 67 OR 68 OR 69 OR 70, 79 72 OR 73 OR 74 OR 75 OR 76 OR 77 OR 78, 81 ((social activit$ OR social network$ OR social life OR freetime OR free time)).ti,ab, 83 ((facilitat$ OR enable$1 OR enabling OR barrier$1 OR obstruct$ OR encourag$ OR prevent$ OR time OR free OR disrupt$ OR relationship$ OR conflict)).ti,ab, 88 ((stress OR burnout OR depression OR depressed)).ti,ab, 89 1 OR 2 OR 3 OR 4 OR 5 OR 6 OR 7 OR 8 OR 9 OR 10 OR 11 OR 12 OR 13 OR 14 OR 15 OR 16 OR 17 OR 18 OR 19 OR 20 OR 21 OR 22 OR 23 OR 24 OR 25 OR 26 OR 27 OR 28 OR 29 OR 30 OR 31 OR 34 OR 35 OR 38 OR 39 OR 40 OR 41 OR 42 OR 43 OR 46 OR 47 OR 48 OR 49 OR 50 OR 51 OR 52 OR 53 OR 54 OR 55 OR 56 OR 57 OR 58 OR 80 OR 81 OR 82 OR 87 OR 88, 99 "flexible work$ arrangement$".ti,ab, 137 "non standard$ employ$ contract$".ti,ab, 138 "nonstandard employ$ contract$".ti,ab, 143 "professional$ help$ with childcare".ti,ab, 144 "professional$ help$ with housework".ti,ab, 145 "professional$ help$ with household work$".ti,ab, 192 ((temp$ employ$ OR temp$ contract$)).ti,ab, 201 ((work adj2 life adj2 polic$)).ti,ab, 210 ((day OR night OR late OR early OR evening OR core OR stagger$ OR compress$ OR irregular)).ti,ab, 211 ((work$ OR shift$1 OR hours$)).ti,ab, 227 90 OR 91 OR 92 OR 93 OR 94 OR 95 OR 96 OR 97 OR 98 OR 99 OR 100 OR 101 OR 102 OR 103 OR 104 OR 105 OR 106 OR 107 OR 108 OR 109 OR 110 OR 111 OR 112 OR 113 OR 114 OR 115 OR 116 OR 117 OR 118 OR 119 OR 120 OR 121 OR 122 OR 123 OR 124 OR 125 OR 126 OR 127 OR 128 OR 129 OR 130 OR 131 OR 132 OR 133 OR 134 OR 135 OR 136 OR 137 OR 138 OR 139 OR 140 OR 141 OR 142 OR 143 OR 144 OR 145 OR 146 OR 147 OR 148 OR 149 OR 150 OR 151 OR 152 OR 153 OR 154 OR 155 OR 156 OR 157 OR 158 OR 159 OR 160 OR 161 OR 162 OR 163 OR 164 OR 165 OR 166 OR 167 OR 168 OR 169 OR 170 OR 171 OR 172 OR 173 OR 174 OR 175 OR 176 OR 177 OR 178 OR 179 OR 180 OR 181 OR 182 OR 183 OR 184 OR 185 OR 186 OR 187 OR 188 OR 189 OR 190 OR 191 OR 192 OR 193 OR 194 OR 195 OR 196 OR 197 OR 198 OR 199 OR 200 OR 201 OR 204 OR 205 OR 206 OR 207 OR 208 OR 209 OR 212 OR 213 OR 214 OR 215 OR 216 OR 217 OR 218 OR 219 OR 222 OR 223 OR 224 OR 225 OR 226, 228 (work OR workplace OR employment).ti,ab, 229 ((company OR companies) adj5 (work$ OR employ$ OR job$ OR staff OR personnel OR business$)).ti,ab, 230 ((factory OR factories OR human resource$ OR Business$)).ti,ab, 231 (("Small and medium enterprises" OR SMEs)).ti,ab, 232 ((worker$ OR workplace$ OR worksite$ OR staff OR personnel)).ti,ab, 235 ((work place$ OR work site$ OR work location$ OR work setting$)).ti,ab, 237 ((place$ OR site$ OR location$ OR setting$)).ti,ab, 239 228 OR 229 OR 230 OR 231 OR 232 OR 233 OR 234 OR 235 OR 238, ((DE=(health or wellbeing or wellbeing) or DE=morbidity), or(KW=((back pain) or Backpain or lbp) or KW=((low back pain) or lumbago, or (cardiovascular diseases)) or KW=((heart diseases) or hypertension or, (mental health))) or(KW=((psychological outcome*) or Anxiety or, (Professional burnout)) or KW=((Psychological stress) or depression or, ("quality of life")) or KW=((job satisfaction) or Empower* or (decision, latitude))) or(KW=((work life balance) or (worklife balance) or (work, family conflict*)) or KW=(musculoskeletal within 2 disorder*)), or(KW=(musculo within 2 skeletal within 2 disorder*)) or(KW=((promot* or, manag* or facilitat* or enable*1 or enabling or barrier*1 or increas* or, obstruct* or encourag* or prevent* or time or free or disrupt* or, relationship* or conflict) within 2 (health or healthy or healthier))), or(KW=(mental health or physical health or health risk* or general, health)) or(KW=((employee* or staff) within 2 (health))) or(KW=((health, of worker*) or illness or ill) or KW=((sick* absence*) or (sick* leave))), or(KW=((days off) or (quality of life) or (general health questionnaire)), or KW=((mcGill pain questionnaire) or (blood pressure) or (obesity or, obese or overweight)) or KW=((functional limitations profile) or (short, form 36 or SF36) or (euroqol or EQ5d))) or(KW=((facilitat* or enable*1, or enabling or barrier*1 or obstruct* or encourag* or prevent* or time or, free or disrupt* or relationship* or conflict) within 3 (household work or, house work or chores or hobbies or hobby or friends or family))), or(KW=(social activit* or social network* or social life or freetime or, free time)) or(KW=cholesterol) or(KW=(stress or burnout or depression or, depressed))) and(((KW=((flexible work*) or shiftwork* or (shift work*)), or DE=((flexible work*) or shiftwork* or (shift work*))) or(KW=((non, standard work*) or (nonstandard work*) or (flexible time)) or DE=((non, standard work*) or (nonstandard work*) or (flexible time))), or(KW=((flexible workplace) or (flexible work* condition*)) or, DE=((flexible workplace) or (flexible work* conditions) or (flexible, time))) or(KW=((flexible work* time*) or (flexi time*) or flexitime*) or, KW=((flex time*) or flextime* or flexitime*) or KW=((flexible work*, arrangement*) or (flexible work* hour*) or (work schedule tolerance))), or(KW=(("self schedule*") or selfschedule* or (unusual hour*)) or, KW=((study leave) or (parttime work*) or (part time work*)) or, KW=(weekend work*)) or(KW=(job* share*)) or(KW=((compress* work* hour*), or jobshar* or (stagger* hour*)) or KW=((annual* hour*) or (annualised, hour*) or (annualized hour*)) or KW=((compress* work* week*) or overtime, or (shift work*))) or(KW=(shiftwork* or (night work*) or nightwork*) or, KW=((parental leave) or (long term leave) or sabbatical) or, KW=(secondment or (home work*) or homework*)) or(KW=((work* from home) or, telework* or (irregular work* hours)) or KW=((irregular work*) or (phase, within 2 retire*) or (retirement scheme*)) or KW=((pension scheme*) or, (early retirement) or (maternity leave))) or(KW=((non standard* employ*, contract*) or (nonstandard* employ* contract*) or (freelance* work*)) or, KW=(freelance* or (freelance* work*) or freelance*)) or(KW=((workplace, flexibility) or (work place flexibility) or (flexible contract*)) or, KW=((flexible salary form*) or (working time directive*) or (zero hours)), or KW=(daywork* or (day work*) or piecework*)) or(KW=((piece work*) or, (adjust* hours) or (core hours)) or KW=((stagger* hours) or (time in, lieu) or (time bank*)) or KW=((flexi break*) or flexibreak*)), or(KW=((reduc* hours) or (job split*) or (on call)) or KW=(oncall or (as, needed hour*) or (casual hour*)) or KW=((weekday* swap*) or (week* day*, swap*) or (weekday* swap*))) or(KW=((shift self select*) or (shift, selfselect*) or (week* on week* off)) or KW=((term time work*) or, (termtime work*) or (buyable leave)) or KW=((flexi week*) or (flexi, year*) or (performance related pay))) or(KW=((performancerelated pay) or, (adoption leave) or (adoption leave scheme*)) or KW=((flexi* lunch hour*), or (paternity scheme*) or (parental leave scheme*)) or KW=((dependent*, leave) or (dependent* leave scheme*) or (special leave))) or(KW=((fixed, term contract*) or (fixedterm contract*) or (temp* employ* or temp*, contract*))) or(KW=((marginal employ*) or (contingent employ*) or, (atypical employ*)) or KW=((carer* leave) or (unpaid leave) or, (precarious work*)) or KW=((work life polic*) or (occasional flexibil*))), or(KW=(work within 2 life within 2 polic*)) or(KW=((reduc* within 2 hours), or (job*1 sharing))) or(KW=((compress* within 2 hours) or (annualized, within 2 hours) or (annualised within 2 hours))) or(KW=((day or night or, late or early or evening or core or stagger* or compress* or irregular), within 2 (work* or shift*1 or hours*))) or(KW=(sabbatical* or secondment*, or (career* within 3 break*)) or KW=((home working) or (work* within 2, home))) or(KW=((maternal leave) or (paternal leave) or (adapt* hours)) or, KW=(time banking)) or(KW=((work life or worklife) within 2 (balance*))), or(KW=(flexible within 2 contract*))) and((KW=(work or workplace or, employment)) or(KW=((company or companies) within 5 (work* or employ* or, job* or staff or personnel or business*))) or(KW=(factory or factories or, human resource* or Business*)) or(KW=("Small and medium enterprises" or, SMEs)) or(KW=(worker* or workplace* or worksite* or staff or personnel)), or(KW=(employee* or employer*)) or(KW=(work within 3 office*)), or(KW=(work place* or work site* or work location* or work setting*)), or(KW=((job* or employment) within 2 (place* or site* or location* or, #25 Topic=(followup or longitudinal or prospective* or cohort or evaluation or "before and, #21 Topic=(worker or personnel or employee or employer or work setting* or work, #20 Topic=(work or workplace or employment or compan* or business* or staff or job* or, #19 #18 OR #17 OR #16 OR #15 OR #14 OR #13 OR #12 OR #11 OR #10 OR #9 OR #8, #18 Topic=(reduc* hours or career break* or "working from home" or adapt* hours or time, #17 Topic=(atypical employ* or carer* leave or unpaid leave or precarious work* or work, #16 Topic=(fixed term contract* or temp* employ* or temp* contract* or marginal employ*, #15 Topic=(flexi week* or flexi year* or flexi day* or performance related pay or parental, leave scheme* or dependent* leave or special leave), #14 Topic=(shift self select* or shift selfselect* or "week* on week* off" or termtime, work* or term time work* or buyable leave), #13 Topic=(job split* or on call or oncall or oncall or "as needed hours" or casual hours or, #12 Topic=(day work or daywork or piecework* or piece work* or adjust* hours or core, hours or stagger* hours or tme in lieu or time bank* or flexi break* or flexibreak* or, #11 Topic=(work* flexibility or flexible contract* or flexible salary form* or working time, #10 Topic=(maternity leave or paternity leave or adoption leave or nonstandard employ*, #9 Topic=(home work* or homework* or work* from home or telework* or irregular, #8 Topic=(shiftwork* or shift work* or nightwork* or night work* or parental leave or, long term leave or sabbatical or secondment), #7 Topic=(jobshar* or job shar* or compress* work* hour* or stagger* hour* or annual*, hour* or compress* work* week or overtime), #6 Topic=(work schedule tolerance or selfschedul* or self schedul* or unusual hour* or, parttime work* or part time work* or weekend work*), #5 Topic=(flex* work* or flex* workplace or flex* work* condition* or flex* work* time*, #3 Topic=(illness or ill or sick* absence* or sick leave or gp or hospital appointment* or, medical consultation or doctor* appointment or days off or cholesterol or blood pressure, or obesity or obese or "social wellbeing" or social life or free time), #2 Topic=(wellbeing or wellbeing or depression or "quality of life" or job satisfaction or, empower* or decision latitude or "work life balance" or work family conflict* or, musculoskeletal disorder* or health or physical health or health risk* or "general health", #1 Topic=(morbidity or backpain or back pain or lbp or lumbago cardiovasular or heart, disease* or hypertension or mental health or psychological outcome* or anxiety or, 1.
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