Health status,work limitations,and return-to-work trajectories in injured workers with musculoskeletal disorders

BACKGROUND: The purpose of this study was to describe the health status and work limitations in injured workers with musculoskeletal disorders at 1 month post-injury, stratified by return-to-work status, and to document their return-to-work trajectories 6 months post-injury. METHODS: A sample of 632 workers with a back or upper extremity musculoskeletal disorder, who filed a Workplace Safety and Insurance Board lost-time claim injury, participated in this prospective study. Participants were assessed at baseline (1 month post-injury) and at 6 months follow-up. RESULTS: One month post-injury, poor physical health, high levels of depressive symptoms and high work limitations are prevalent in workers, including in those with a sustained first return to work. Workers with a sustained first return to work report a better health status and fewer work limitations than those who experienced a recurrence of work absence or who never returned to work. Six months post-injury, the rate of recurrence of work absence in the trajectories of injured workers who have made at least one return to work attempt is high (38%), including the rate for workers with an initial sustained first return to work (27%). CONCLUSIONS: There are return-to-work status specific health outcomes in injured workers. A sustained first return to work is not equivalent to a complete recovery from musculoskeletal disorders.     

健康教育与大众媒体互动合作机制的定性研究

目的了解大众媒体报道艾滋病的现状，探索大众媒体与健康教育机构之间的互动合作模式。方法以艾滋病的宣传报道为切入点，对15名从事艾滋病宣传报道的负责人或记者进行个人深入访谈。结果影响大众媒体与健康教育机构之间合作的因素主要是资金、观念与机制。大众媒体与健康教育机构之间合作的最佳方式是相互理解、优势互补，建立健全双方长期、定时的信息交流机制和良好的互动合作机制，前者提供宣传平台，后者提供健康信息。结论大众媒体与健康教育机构之阃的合作既有基础，又有必要。加强两者的合作，将是一项双赢的策略。     

Income-related health inequality in Belgium: a longitudinal perspective

This paper provides new evidence on the degree of income-related inequality in self-assessed health in Belgium. First of all, we combine the time dimension, which has been shown to be very important in the analysis of inequality, and the use of the recently developed interval regression approach to transform a categorical health variable in a continuous one. Second, we measure how the long-run inequality differs from the short-run inequality. Finally, we decompose this health-related income mobility index as well as the long-run concentration index (CI) itself into its contributors. Using data from the panel survey of Belgian households (1994–2002), we find that health is pro-rich distributed and that its inequality is underestimated by 9.45% when neglecting the dynamics of individuals over time. Income, education, job status and age are the most important contributors in the CI and the difference between the short-run and long-run inequality.      

行为干预对慢性乙型肝炎患者健康相关行为影响的研究

目的 观察行为干预对慢性乙型肝炎患者健康行为的影响。方法 将300例慢性乙型肝炎患者作为目标人群进行健康教育，建立目标人群管理档案，进行目标人群健康行为干预，比较教育前后相关行为的改变。结果 慢性乙型肝炎患者8项健康行为和8项危险健康行为有明显改观，差异具有统计学意义（P〈0．01）。结论 通过行为干预，有效地使慢性乙型肝炎患者完全遵从医嘱合理用药，完全依从健康行为，从而减少危险行为的发生。     

Pharmaceutical Policy and the Lay Public*

Almost every national and supranational health policy document accords high importance to the need to listen to and ‘empower’ patients. The relationship between pharmaceutical policy and the lay public is not direct but mediated by several actors, including health care workers, patient organisations, industry and, most recently, the media. Although the overall aim of health and pharmaceutical policy is to address the needs of all citizens, there are only a few, well organised groups who are actually consulted and involved in the policymaking process, often with the support of the industry. The reasons for this lack of citizen involvement in health and pharmaceutical policymaking are many, for example: there is no consensus about what public involvement means; there is a predominance of special interest groups with narrow, specific agendas; not all decision makers welcome lay participation; patients and professionals have different rationalities with regard to their views on medicine. Because the lay public and medicine users are not one entity, one of the many challenges facing policy makers today is to identify, incorporate and prioritise the many diverse needs. The authors recommend research which includes studies that look at: lay attitudes towards pharmaceutical policy; lay experiences of drug therapy and how it affects their daily lives; the problem of identifying lay representatives; the relationship between industry and the consumers; the effect of the media on medicine users and on pharmaceutical policy itself. The authors acknowledge that although lay involvement in policy is still in its infancy, some patient organisations have been successful and there are developments towards increased lay involvement in pharmaceutical policymaking. This article is the fourth in a series of articles on this topic that will appear in Pharmacy World & Science during 2005.     

心理保健教育对入伍新兵人格特征的影响

目的：探讨心理保健教育对新兵个性特征的影响。方法：采用：采用修订的成人艾森克个性问卷（EPQ）对2180名新兵个性特征进行调查，尔后以《军人精神卫生保健常识》为教材对他们进行心理健康保健教育，三年后对1533名完成者再次进行EPQ调查。结果：新兵及其自身对照级精神质（P）量表分均低于袭氏和艾氏常模，而内外向（E）量表分、神经质（N）量表分和效度（L）量表分均低于袭氏和艾氏常模，新兵内外向（E）量表分高于其自身对照组，而精神质（P），神经质（N）及效度（L）量表分则低于其自身对照组，而中间、外向、倾向外向则高于自身对照组（P＜0．05）；情绪稳定性也以中间型为多（分别为65．27％和68．95％），稳定和中间入伍新兵低于自身对照组，而倾向不稳定和不稳入伍则高于自身对照组（P＜0．01）。结论：心理保健教育对新兵个性特征有积极的影响。     

New South Wales Nurse Education Project

Abstract: The development of a teaching package for nurse educators on drug and alcohol problems is described and the contents of its 16 modules outlined.     

教育研究中的问题及评价

教育科学研究是探索和揭示教育过程中未被认识或未被完全认识的现象、本质和规律的一种活动。而问题研究又是教育科学研究的关键,能否选择一个真问题进行研究将直接决定教育科学研究的质量与成败。本文从问题的概念分析入手,从传统认识论中真理论的观点出发并综合多位学者的观点探讨了什么是真问题,最后粗浅地分析了教育课题研究中的真问题。     

The Renal Diabetic Nurse Specialist… A luxury or an essential player?

Diabetic Nephropathy is the single largest cause of Chronic Renal Failure. As the number of patients referred to a nephrologist increase, the needs of many diabetic nephropaths are not being met. The post of Renal Diabetes Nurse Specialist (DNS) was instituted in September 1999 to organise the management of and to meet all aspects of need of this group of patients. The role currently incorporates a daily ward round with the aim of reviewing all patients at least once during every admission to hospital. Ward‐based teaching with the patients occurs and six nurse‐led clinics covering all modalities are now in place and run alongside the Nephrologist. Patients are either referred directly to the nurse‐led clinic or are approached by the renal DNS whilst the patient is in the nephrology clinic. 71.4% of our diabetic patients have an improvement in their HbA1c after 21 months of working closely with the Renal DNS and multidisciplinary team. The average HbA1c at the beginning was 9.7%; the average is now 8%. It is clear that the role is being continuously stretched to its absolute limit. Our aim is to develop a broader service over time and we will, in the near future be employing a renal nurse with an interest in diabetes to work alongside the DNS for six months to particularly learn about the needs of our in‐patients.