Occupational activity is associated with knee cartilage morphology in females

Introduction

Knee osteoarthritis (OA) is a major cause of pain and disability in women, becoming a major health problem in mid to later life. A better understanding of factors contributing to deleterious structural knee changes may be important for preventing OA. In men, occupations associated with frequent knee bending have been shown to be associated with damage to knee cartilage. This has not been examined in women. The aim of this study was to examine the effect of occupational specific knee activities on tibial and patella cartilage morphology among healthy females.

Methods

96 females aged 26–62 years with no history of knee injury or symptoms were recruited as part of a study of community-based study of lifestyle factors on knee health. Occupational activity data examining the frequency of tasks such as heavy lifting, knee bending, stair climbing, walking and standing were obtained by questionnaire. Tibial and patella cartilage volumes and defects were measured from magnetic resonance imaging using validated methods.

Results

Heavy lifting/bending/squatting, knee bending, stair climbing and walking were all associated with an increased risk of patella, but not tibial, cartilage defects (odds ratio 1.8–2.9; p ≤ 0.05) after adjustment for potential confounders, including knee alignment and radiographic joint space narrowing. There was a trend towards knee bending being associated with a reduction in patella cartilage volume (p = 0.07).

Conclusion

Our results demonstrate that asymptomatic adult females with occupations requiring frequent knee bending have patella, but not tibial cartilage damage. These findings suggest that vocational tasks requiring knee bending are detrimental to the structure of cartilage in females and may be an area to consider in the prevention of knee OA.     

工作相关社交技能训练对抑郁症患者职业康复的效果

目的 探讨工作相关社交技能训练对抑郁症患者职业康复的影响.方法 将100例患者随机分为研究组和对照组各50例,对照组接受一般门诊咨询和随访服务,研究组在此基础上进行工作相关社交技能训练（WSST）,疗程为10周.在入组前、训练结束后随访3个月时对两组患者采用汉密尔顿抑郁量表（HAMD-24）和工作社交技巧评估量表（WSSS）进行评定,同时统计两组找到竞争性工作岗位的例数.结果 训练前两组在HAMD、WSSS评分差异无统计学差异（P＞0.05）,训练结束后随访3个月两组HAMD、WSSS评分差异有统计学差异（P＜0.01）,研究组有12例找到竞争性工作岗位,对照组有4例找到竞争性工作岗位.结论 工作相关社交技能训练可以改善抑郁症患者的症状,提高就业比率.     

Costs of needlestick injuries and subsequent hepatitis and HIV infection

ABSTRACT

Background: Physicians, nurses and other healthcare workers (HCWs) are at risk of bloodborne pathogens infection from needlestick injuries, but costs of needlesticks are little studied.

Methods: We used the cost-of-illness and incidence approaches. We used the perspective of the medical provider (medical costs) and the individual (lost product­ivity). Data on needlesticks, infections from hepatitis B and C (HBV, HCV) and human immune-deficiency (HIV) among HCWs, as well as data on per-unit costs were culled from research literature, Centers for Disease Control and Prevention reports, and Bureau of Labor Statistics reports. We also generated estimates based upon industry employment and scenarios for source-patients. These data and estimates were combined with assumptions to produce a model that generated base-case estimates as well as one-way and multi-way probabilistic sensitivity analyses. Future costs were discounted by 3%.

Results: We estimated 644?963 needlesticks in the healthcare industry for 2004 of which 49% generated costs. Medical costs were $107.3 million of which 96% resulted from testing and prophylaxis and 4% from treating long-term infections (34 persons with chronic HBV, 143 with chronic HCV, and 1 with HIV). Lost-work productivity generated $81.2 million, for which 59% involved testing and prophylaxis and 41% involved long-term infections. Combined medical and work productivity costs summed to $188.5 million. Multi-way sensitivity analysis suggested a range on combined costs from $100.7 million to $405.9 million.

Conclusion: Detailed methodology was developed to estimate costs of needlesticks and subsequent infections for hospital-based and non-hospital-based health care workers. The combined medical and lost productivity costs comprised roughly 0.1% of all occupational injury and illness costs for all jobs in the economy. We did not account for lost home production or pain and suffering costs, however, nor did we estimate benefit/cost ratios of specific interventions to reduce needlesticks.     

高职护生综合素质和职业能力的培养

随着医学科学的发展和现代护理观的改变,学生综合素质和职业能力培养成为护理职业教育面临的重要课题.本文阐述了综合素质和职业能力的内涵与关系,并从调整课程设置、改进教学方法等方面提出了提高护生综合素质和职业能力培养的有效措施.     

四川省中小学教师职业心理健康筛查量表编制

摘要:目的　编制四川省中小学教师职业心理健康筛查量表。方法　将职业心理健康作为一个连续谱来测量,参照临床诊断标准（CCMD-3）、《中小学教师职业道德规范》和文献资料设计条目,用德尔菲法筛选条目形成初始量表,在四川省随机抽取500名中小学教师,对404份合格问卷采用探索性因子分析和验证性因子分析,提炼出教师职业心理健康的维度,综合运用离散程度法、相关系数法、回归系数法和t检验法筛选出敏感的、独立的、有代表性的和重要的条目。结果　获得的量表包括强迫、神经衰弱、焦虑、抑郁、职业倦怠、人格障碍和积极心理7个分量表总共28个条目,Cronbach's Alpha信度为0.857,具有较好的可操作性、内容效度、效标效度和结构效度（主要拟合指标均大于0.90,RMSEA＝0.040）。结论　量表可用于对中小学教师职业心理健康状况进行筛查。     

Occupational exposure to chemicals and risk of thyroid cancer in Sweden

Purpose  To explore thyroid cancer (TC) risk in the Swedish population, associated with occupational exposure to certain chemicals. Methods  National cancer and death registries were used to follow-up (1971–1989) all Swedish workers employed in the 1970 census. Each combination of occupation and industry was linked to a Swedish job-exposure matrix (JEM), with exposure to 13 chemicals classified as “possible exposure”, “probable exposure” or “unexposed”. Relative risks were obtained using Poisson models adjusted for age, period and geographical area. A second analysis was performed, in which adjustment was additionally made for simultaneous exposure to other matrix chemicals and ionising radiations. Results  Probable exposure to solvents among women displayed an increased risk (RR = 1.91; 95%CI:1.05–3.45), mainly due to a higher risk observed among shoe-cutters, lasters and sewers engaged in shoe-making. Conclusions  Exposure to solvents, used mainly in the shoe and leather industry, seems to be associated with excess TC among women.     

Everyday occupations prioritised by older adults participating in reablement. A cross-sectional study

Abstract

Background: Little knowledge exists regarding which occupations older adults prioritize as rehabilitation goals in reablement and what factors are associated with their preferences.

Objectives: To explore which occupations older people with functional decline find important to improve, which of these they prioritize as their rehabilitation goals, and what factors are associated with these priorities.

Materials and methods: A cross-sectional study was undertaken with a sample of 738 older adults from a nationwide trial evaluating the effects of reablement in Norway. The nine occupational sub-areas of the Canadian Occupational Performance Measure were used as a framework for analyses.

Results: Participants identified a multitude of occupations as challenging. Functional mobility was the most frequently identified and prioritized sub-area. Significant associations were found between prioritized occupations and health condition, sex, living status, education, walking speed and motivation.

Conclusions: This study found both abundance and diversity in the occupational problems and prioritized goals of older adults, with mobility being a key priority regardless of health condition.

Significance: It is important that reablement continues to be a person-centered intervention embracing the possibility to choose meaningful occupations. Occupational Therapists and other health professionals should address mobility when improving occupational performance in older adults.     

Socio-economic position and cardiovascular risk factorsin an Italian rural population

Cardiovascular disease (CVD) is the leading industrial world cause of mortality. Lower social class groups have higher incidence of CVD and also display less favourable risk factor profiles. To investigate the association and gradient between major cardiovascular risk factors (smoking habit, serum lipid profile, blood pressure, relative body weight) and socio-economic position (proxy measures selected: education and occupation) data on 2592 men and 2866 women were analysed. The effect of potential confounding factors and effect modifiers was estimated. Linear and logistic regression modelling was performed for continuous and dichotomous outcomes respectively. The lower the grade of employment or the level of education, the higher was the prevalence of obesity in the study population. The association was stronger in women than in men. Higher education was associated with a lower prevalence of smoking among men and a higher prevalence among women. Systolic blood pressure was negatively related to socio-economic position in both men and women in the age-adjusted models. Attention should be concentrated on socio-economic differences in obesity and blood pressure in this population.     

某石化动力厂作业环境职业病危害调查

目的了解某石化动力厂职业病危害现况。方法对某石化动力厂作业环境进行调查;对动力厂807人(暴露组)、港口分部671人(对照组)进行职业健康检查及调查分析。结果动力厂存在多个噪声、粉尘、高温超标点;动力厂370名噪声接触者,检出听力下降29人,与对照组比较,差异有统计学意义(P0.01)。结论某石化动力厂存在多种较严重职业病危害,其中接触人数最多、危害最严重的是噪声因素。