Implementing a Stratified Vocational Advice Intervention for People on Sick Leave with Musculoskeletal Disorders: A Multimethod Process Evaluation

Journal of Occupational Rehabilitation - Purpose To perform a process evaluation of a stratified vocational advice intervention (SVAI), delivered by physiotherapists in primary care, for people on...     

Birth-Related Exposures and Asthma and Allergy in Adulthood: A Population-Based Cross-Sectional Study of Young Adults in North Staffordshire

The rise in the prevalence of asthma and other allergic disorders over the past two decades has been well documented, yet this increase has still to be fully explained. One possible hypothesis is that the rise in atopic disease is related to recent changes in obstetric practice. Using a population based survey, with linked general practice and hospital birth records, we investigated the association between 6 birth related exposures (birth weight, mode of delivery, artificial commencement of labour, prematurity, neonatal intensive care unit admission and foetal distress) and asthma, allergic rhinitis, eczema and hay fever in adulthood. No statistically significant associations were demonstrated between any of the birth-related exposures and the 4 allergic conditions studied, although some non-significant trends were noted, especially for those born by Caesarean section (asthma: odds ratio 1.71, 95% confidence interval 0.75, 3.86, eczema: 1.09, 95% CI 0.41, 2.91, hay fever: OR 1.36, 95% CI 0.51, 3.61) (Table 2) or having evidence of foetal distress during labour (asthma: OR 1.45, 95% CI 0.70, 3.02, rhinitis OR 2.82, 95% CI 0.87, 9.15, hay fever OR 1.34, 95% CI 0.57, 3.14). Given the ongoing changes in obstetric practice and the continuing rise in the prevalence of allergic disorders, this area is worthy of further investigation.     

Sickness certification for musculoskeletal conditions

Clinical Rheumatology -     

Identification of UK sickness certification rates,standardised for age and sex

Background

There is growing interest in tackling the perceived ‘sick note’ culture in the UK.

Aim

The aim of this paper was to report the rates of sickness certification in a UK population, using sick certification rates as a precursor to addressing fitness for work.

Method

Electronic records from all 14 practices included in the Keele GP Research Network were reviewed; all sickness certification records from 2005 were retrieved and corresponding consultation records were examined. Participants were 148 176 patients registered during 2005, including 6398 patients who received at least one sickness certificate during the same year.

Results

The rate of sickness certification was 101.67 certificates per 1000 person years (95% confidence interval [CI] = 100.13 to 103.21). This rate was significantly higher in women, at 109.76 certificates per 1000 person years (95% CI = 107.550 to 112.02), compared to men who had a rate of 93.68 certificates per 1000 person years (95% CI = 91.59 to 95.78; P<0.001). The rate of sickness certification was greatest for mental health conditions, followed closely by musculoskeletal conditions.

Conclusion

On average, one in 10 patients will receive a sickness certificate each year, with the highest rates occurring around 50 years of age, in women. Mental health and musculoskeletal conditions were associated with the highest rates of certification. These results provide important information to underpin the national ‘Fit for Work’ scheme, by providing targets for intervention and a benchmark against which the impact of public health initiatives to reduce certified sickness absence due to health conditions can be evaluated and monitored.     

Familial Dandy–Walker syndrome: a case report supporting an autosomal inheritance

Introduction We report an isolated pedigree in which a consanguineous couple had twin sons with Dandy–Walker malformation (DWM). The mother is similarly affected with the disorder.Discussion DWM is an abnormality of the central nervous system, which leads to hydrocephalus and is associated with other abnormalities.Conclusion Inheritance of the disorder remains controversial, with the majority perceived to be sporadic cases. This report suggests an autosomal inheritance.