Individual and combined impacts of biomechanical and work organization factors in work-related musculoskeletal symptoms

BACKGROUND: Investigations of work-related low back (LB) and upper extremity (UE) disorders have increasingly utilized multivariable models that include biomechanical/physical and work organization factors. However, the nature of any interactive effects is not well understood. METHODS: Using questionnaires, high and low exposure groups for biomechanical/physical factors, cognitive demands, cognitive processing, interpersonal demands, participatory management, skill discretion, and time pressure for 289 individuals (U.S. Marines) were identified. Musculoskeletal symptom status was also determined by questionnaire. Individual and biomechanical-psychosocial combinations were examined in adjusted multivariable logistic regression analyses. RESULTS: Time pressure was associated with both LB and UE symptoms (odds ratio(s) (OR) range = 2.13-3.09), while higher biomechanical exposures were risk factors for LB symptoms (OR = 2.07; 95% confidence intervals (CI): 1.00-4.35) and concurrent LB and UE symptoms (OR = 2.80; CI: 1.35-5.83). Greater risks for concurrent LB and UE symptoms were indicated for combinations involving higher biomechanical exposure and: time pressure (OR = 2.21; CI: 1.19-4.10); cognitive demands (OR = 2.25; CI: 1.23-4.09); cognitive processing (OR = 2.08; CI: 1.16-3.75); interpersonal demands (OR = 2.44; CI: 1.35-4.41); participatory management (OR = 2.50; CI: 1.30-4.81). Results did not suggest any interaction between biomechanical and work organization factors. CONCLUSIONS: While no synergism was indicated, the present findings emphasize the need to consider both biomechanical factors and specific work organization factors, particularly time pressure, in reducing musculoskeletal-related morbidity.     

Recurrent eosinophilic mastitis

Systemic diseases rarely present with manifestations in the breast. Disorders such as sarcoidosis and pyoderma gangrenosum have been described to produce signs and symptoms in the breast. Peripheral eosinophilia is a systemic disease associated with a finite group of conditions including asthma, allergic or atopic disease, collagen vascular disease, and parasitic infection. In addition it has been described in association with several malignancies. A 50-year-old woman with a history of asthma and significant eosinophilia presented with an enlarging breast mass. Complete excision of the mass revealed eosinophilic mastitis. Two years later the patient again presented with a large mass in the same breast. Repeat excision demonstrated the same pathology. The clinical significance of this lesion is important because it presents as an enlarging, painless, dominant mass. Excision is necessary for management and to conclusively rule out malignancy. Its recurrence despite excision to negative margins, however, may indicate that control of the eosinophilia--and possibly the underlying disorder--is important to prevent further recurrence.     

Psychiatric outcomes amongst adult survivors of childhood burns

Background

Research on the adult psychiatric outcomes of childhood burns is limited.

Aims

To examine the rates of DSM-IV psychiatric disorder amongst adult survivors of paediatric burns, and to explore factors likely to contribute to variation in outcomes. In line with Meyer and colleagues [1], it was expected that high levels of psychopathology would be found.

Method

Participants were 272 adults hospitalised for burns during childhood between the years 1980 and 1990. Structured interviews and self-report questionnaires were used to assess psychiatric symptoms.

Results

Lifetime prevalence of any DSM-IV disorder was 42%, 30% for depressive disorders, and 28% for anxiety disorders. Eleven percent had made a suicide attempt. Female gender, single relationship status, higher level of disfigurement, longer hospital stays and higher number of burn-related surgeries were associated with adverse psychiatric outcomes.

Conclusions

High rates of suicidality and depression were concerning in adults with a history of childhood burns. Factors found to predict psychiatric outcomes could be used to direct interventions and further research is needed to establish how this could best be done.     

“When Looking Back on My Past Life I Regret…”: Retrospective Regret in the Second Half of Life

ABSTRACT

The study investigated the frequency, themes, and attributions for significant regrets in a random probability sample of 3,917 German and Dutch nationals between the ages of 40 and 85 years. It was found that 14% did not have any regrets in spontaneous memory, and that this increased with the age of the respondents. With respect to mentioned regrets, older people, women, and those living in the former East Germany were more likely to recall externally attributed events; younger participants, men, West Germans, and the Dutch recalled more internally attributed events. Largely, memories related to 4 major themes: (a) mistakes, behavior, and bad decisions in general; (b) hard times; (c) social relationships; and (d) missed educational opportunities. The importance of these themes, however, varied according to age, gender, and regional belonging. Differences in the kind of attribution and in the centrality of themes are discussed in terms of lifespan theory, death preparation, and cultural differences.     

Adolescents' Reports of Communication With Their Parents About Sexually Transmitted Diseases and Birth Control: 1988, 1995, and 2002

PurposeWe examine trends in adolescents' reports of discussion with parents about sexually transmitted diseases (STDs) and birth control methods from 1988 to 2002.MethodsData from the 1988 and 1995 National Survey of Adolescent Males, and the 1988, 1995, and 2002 National Survey of Family Growth were analyzed to evaluate changes in discussions of female adolescents with parents about birth control methods and STDs, and changes in male adolescent discussions with parents about birth control methods. The sample includes never married males and females aged 15–17 years.ResultsIn 2002, fewer female adolescents reported discussion with a parent about STD or birth control methods than in 1995. The share of female adolescents in 2002 reporting no discussion of either topic with their parents increased by almost half compared to 1995. Patterns across time in male adolescents' discussions of birth control methods with their parents appear stable.ConclusionsThe recent decline in female adolescent reports of parent-communication about birth control and STDs, and the increase in female adolescent reports of no discussion of either topic suggest that public health officials, educators, and clinicians should invigorate their efforts to encourage parents to talk with their children about STDs and birth control.     

The Impact of Physical,Intellectual and Social Impairments on Survival in Adults with Intellectual Disability: A Population‐Based Register Study

Background Research into factors associated with survival in adults with intellectual disability is limited and no studies have controlled for changes in these factors over time. Material and Methods All adults aged ≥20 years with moderate to profound intellectual disability (approximate IQ < 50) using specialist services in Leicestershire and Rutland, UK, were identified. The relationship between survival and physical, intellectual and social impairments was investigated, also adjusting for age, sex, ethnicity and exact year of birth. Results Of 2453 adults studied, 402 (16%) died over a maximum follow‐up period of 19 years. While physical, intellectual and social impairments were all associated with survival individually, physical impairment was the only impairment to significantly predict survival in the multi‐variable analysis. Being non‐mobile was associated with a sevenfold increased risk of death and being partially mobile with a twofold increased risk of death compared with being fully mobile [adjusted hazards ratios (HR) = 7.14; 95% confidence interval (CI) 4.99–10.21 and HR = 2.33; 95% CI 1.84–2.95]. Being male and earlier year of birth were also associated with shorter survival. Conclusions The implications of these findings are discussed.     

The Leicestershire Intellectual Disability Tool: A Simple Measure to Identify Moderate to Profound Intellectual Disability

Background It is often useful to ascertain whether adults have moderate to profound intellectual disability (approximate IQ < 50; developmental age <108 months) when deciding whether to refer to specialist or mainstream services. The aim of the present study was to develop a simple measure to estimate moderate to profound intellectual disability in adults with a potential need for specialist care. Materials and Methods Three hundred and twenty‐two individuals with information on home interviews from the Leicestershire Learning Disability Register were also assessed using the Vineland Adaptive Behaviour Scales. A variety of variables concerning intelligence, adaptive functioning and dependency were used to predict developmental age (as estimated from the Vineland) using backward stepwise regression. The derived equation formed the Leicestershire Intellectual Disability (LID) tool. A cut‐off point was chosen using a receiver operator characteristic (ROC) curve to achieve 95% sensitivity in identifying moderate to profound intellectual disability. Results Seven variables from the home interviews were found to predict estimated developmental age at the 10% level (P ≤ 0.1). When the tool was used to detect adults with moderate to profound intellectual disability, the area under the ROC curve was 0.93. The chosen cut‐off point was 95% sensitive and 65% specific. The positive predictive value was 95%, the negative predictive value was 65%, and the overall diagnostic accuracy was 91%. Conclusions These preliminary findings suggest that the LID tool may help to identify adults with moderate to profound intellectual disability among those with potential need for specialist care. Further evaluation is recommended.     

Effects of the Neonicotinoid Insecticide Clothianidin on Southern Leopard Frog (Rana sphenocephala) Tadpole Behavior

Bulletin of Environmental Contamination and Toxicology - Neonicotinoid insecticides are highly water soluble with relatively long half-lives, which allows them to move into and persist in aquatic...