The Practical Application of Theory and Research for Preventing Work Disability: A New Paradigm for Occupational Rehabilitation Services in China?

Introduction Theoretical frameworks for preventing work disability have evolved over the last decade and various experimental models have been tested in occupational rehabilitation settings. The successful application and uptake of the most recent research evidence in rehabilitation practices depend on a complex interplay of the decisions of multi-stakeholders, including their perceptions of the evidence, a proper regulatory framework for injury prevention, compensation and disability management; as well as the cultural and socioeconomic factors unique to each country (social context). This paper summarizes the scope of the work disability prevention field and describes the contextual barriers and support mechanisms for implementing evidence-based practices for disability prevention in China’s national rehabilitation system. Methods Expert opinions and relevant publications in the field were reasoned around key constructs of a translational model used to identify potential barriers and support platforms for research uptake in China. Results A crucial component of experimental models for disability prevention is to promote well-coordinated return to work actions centred in the workplace. Potential barriers and support mechanisms for implementing this and other evidence-based recommendations in China are described. Conclusions The complexity of implementing a system-wide disability prevention model in a country as large and diverse as China is well-recognized. Improved efforts are thus required for international knowledge-sharing that can empower greater research utilization of effective disability prevention methods in China. The development of well-connected communities of practice might be a helpful strategy for enhancing stakeholders’ perceptions, attitudes and collaborative efforts towards locally relevant and cultural sensitive solutions to work disability.     

Learning From Successful Interventions: A Culturally Congruent HIV Risk�CReduction Intervention for African American Men Who Have Sex With Men and Women

Few HIV prevention interventions have been developed for African American men who have sex with men or who have sex with both men and women. Many interventions neglect the historical, structural or institutional, and sociocultural factors that hinder or support risk reduction in this high-risk group.We examined ways to incorporate these factors into Men of African American Legacy Empowering Self, a culturally congruent HIV intervention targeting African American men who have sex with men and women.We also studied how to apply key elements from successful interventions to future efforts. These elements include having gender specificity, a target population, a theoretical foundation, cultural and historical congruence, skill-building components, and well-defined goals.AFRICAN AMERICAN MEN WHO have sex with men (MSM) or who have sex with both men and women (MSMW) have the highest HIV prevalence among African Americans and among other racial/ethnic groups of MSM.^1–3 However, HIV risk behaviors alone do not explain the disproportionate HIV rates among African American MSM.^4,5 Attention to the sociocultural challenges facing African American MSM is needed.Only 1 published HIV behavioral intervention targets African American MSM⁶; none specifically target African American MSMW. Inclusion of culture is believed to improve the ability of public health programs to meet members'' needs.^7–9 However, inherent abstractness and a lack of operationalized definitions and cultural competency pose challenges for those designing and implementing interventions.^10–14 Understanding the experiences of African American MSM requires attention to definitions of what it means to be African American and of male sexuality that are rooted in African American history and culture. Choices regarding identification with gay or bisexual labels and disclosure of Black same-gender sexual activities must be contextualized within African American communities.^15–17Health improvement among African American MSM requires attention to racism; gender role expectations; connection to partners, families, and communities; and HIV-related stigma.^18–22 Double minority status is made worse by high HIV rates and perceived responsibility for spreading HIV.^23–25 Even if family and community provide social support, homophobia and racism can deter African American MSM from disclosing their sexuality and seeking HIV prevention and care.²⁶ Interventions must engage protective factors and address structural or institutional and sociocultural barriers to prevention.     

Impact of a Brief Group Intervention to Enhance Parenting and the Home Learning Environment for Children Aged 6–36 Months: a Cluster Randomised Controlled Trial

This study evaluated the effectiveness of a group parenting intervention designed to strengthen the home learning environment of children from disadvantaged families. Two cluster randomised controlled superiority trials were conducted in parallel and delivered within existing services: a 6-week parenting group (51 locations randomised; 986 parents) for parents of infants (aged 6–12 months), and a 10-week facilitated playgroup (58 locations randomised; 1200 parents) for parents of toddlers (aged 12–36 months). Each trial had three conditions: intervention (smalltalk group-only); enhanced intervention with home coaching (smalltalk plus); and ‘standard’/usual practice controls. Parent-report and observational measures were collected at baseline, 12 and 32 weeks follow-up. Primary outcomes were parent verbal responsivity and home learning activities at 32 weeks. In the infant trial, there were no differences by trial arm for the primary outcomes at 32 weeks. In the toddler trial at 32-weeks, participants in the smalltalk group-only trial showed improvement compared to the standard program for parent verbal responsivity (effect size (ES)?=?0.16; 95% CI 0.01, 0.36) and home learning activities (ES?=?0.17; 95% CI 0.01, 0.38) but smalltalk plus did not. For the secondary outcomes in the infant trial, several initial differences favouring smalltalk plus were evident at 12 weeks, but not maintained to 32 weeks. For the toddler trial, differences in secondary outcomes favouring smalltalk plus were evident at 12 weeks and maintained to 32 weeks. These trials provide some evidence of the benefits of a parenting intervention focused on the home learning environment for parents of toddlers but not infants. Trial Registration: 8 September 2011; ACTRN12611000965909.     

Functional neuroimaging in patients presenting with somatoform disorders: A model for investigating persisting symptoms after tick bites and post-treatment Lyme disease syndrome?

Approximately 10% of patients presenting with Lyme disease experience fatigue, musculoskeletal pain, concentration disorders, or short-term memory deficits in the six months following treatment. This entity has been defined as post-Lyme disease syndrome or post-treatment Lyme disease syndrome. The pathophysiology of this syndrome is unknown, but neither persistence of the bacterium nor effectiveness of antibiotics are currently reported in the literature. The French High Council for Public Health (French acronym HCSP) has recently defined a new entity called “persistent polymorphic symptoms after a tick bite” allowing for designing studies to better understand these subjective presentations, for which objective biomarkers are currently lacking. This entity encompasses patients experiencing fatigue and generalized pain in the months following a tick bite and can be associated with several subjective symptoms with major impact on the quality of life. In the field of somatoform disorders, this article reviews functional neuroimaging studies in patients presenting with subjective complaints and discusses potential clinical implications for persisting symptoms after tick bites and post-treatment Lyme disease syndrome.     

A Population Study of 5 to 15 Year Olds: Full Time Maternal Employment not Associated with High BMI. The Importance of Screen-Based Activity,Reading for Pleasure and Sleep Duration in Children’s BMI

To describe the relationship between maternal full time employment and health-related and demographic variables associated with children aged 5–15 years, and the factors associated with child overweight/obesity. Data from a chronic disease and risk factor surveillance system were limited to children aged 5–15 years whose mothers responded on their behalf (n = 641). Univariate/multivariate analyses described the differences between mothers who did and did not work full time. The same data were analysed comparing children who are overweight/obese against those with a normal BMI. The children of mothers who worked full time are more likely to be older, live in a household with a higher household income, be an only child or have one sibling or other child in the household, have a sole mother family structure and not spend any time reading for pleasure. No relationship was found between maternal employment and BMI. Compared with children of normal weight, those who were overweight/obese were more likely to spend no time studying, spend more than 2 h per day in screen-based activity and sleep less than 10 h per night. Child BMI status was not related to maternal employment. Although this analysis included eight diet related variables none proved to be significant in the final models.This study has shown that mothers’ working status is not related to children’s BMI. The relationship between overweight/obesity of children and high levels of screen-based activity, low levels of studying, and short sleep duration suggests a need for better knowledge and understanding of sedentary behaviours of children.