Musculoskeletal health in the workplace

Musculoskeletal (MSK) problems remain the most frequent reason why individuals are absent from work, including those with work-related musculoskeletal disorders (WRMSDs or MSDs) and those with chronic MSK problems. This paper aims to examine changes in work and the workforce since 2000; how work impacts on chronic MSK conditions and how we can help people with these conditions to stay at work. While our knowledge of the causes of WRMSDs has increased since 2000, there has been limited workplace action in reducing exposure to hazards. A life course approach is needed as individuals of all ages are reporting MSK problems. How people work has also changed and informalisation of work contracts has increased with a perceived concurrent reduction in occupational safety and health (OSH) protection. Retaining people at work with MSK problems requires compliance with relevant safety, health and diversity legislation and a risk management approach. Good and open communication within the workplace and identification of other sources of support is also necessary. Considerations must be made at the individual level (internal motivation), organisational level (a supportive manager) and self-management of symptoms. Simple case examples are provided in the paper of what works in practice as well as a proposed research agenda. Increased awareness at all levels of society of MSK health is essential.     

Reliability and Validity of the King's Health Questionnaire for Male Lower Urinary Tract Symptoms in Taiwan

Objectives: To investigate the reliability and validity of the King's Health Questionnaire (KHQ), and understand the impacts of lower urinary tract symptom (LUTS) on health‐related quality of life (HR‐QoL). Methods: A cross‐sectional design was used and a convenience of 393 men participated in the study. The reliability was measured by testing the Cronbach's α coefficients. Factor analysis was used to explore the underlying factor structure of the KHQ. The discriminant validity was assessed using the one‐way analysis of variance (ANOVA) tests with post hoc analysis (Games‐Howell method) by comparing the differences scores in KHQ domains between men with three LUTS severity groups (mild, moderate, and severe). Results: Men with severe, moderate, mild LUTS accounted for 7.9, 25.4, and 66.7%, respectively. Internal consistency of KHQ was excellent with Cronbach's α coefficients of 0.750–0.943. Factor analysis showed three underlying components to explain constructive validity. The KHQ subscores in both the severe and moderate LUTS groups were significantly higher than those in mild LUTS group (all P < 0.05), implying that the discriminant validity was adequate. Excepting for two single‐item questions, the first three greater disparities in KHQ domains between the severe and mild LUTS groups were “Emotion”, “Sleeping/Energy”, and “Physical limitation”, while the least disparities was found in “Personal relationships” domain. Conclusion: LUTS could produce a substantial impact on different domains of HR‐QoL. The traditional Chinese KHQ has suitable reliability and validity for men with general LUTS, and might be a useful tool for HR‐QoL measure in future.     

精准健康管理模式在2型糖尿病中的应用研究进展

2型糖尿病在全球发病率明显增高,已成为第三大慢性非传染性疾病,严重影响了患者的生命质量,且给社会带来了严重的医疗负担。传统的健康管理模式已经不能满足人们日益增长的健康需求,亟待采取有针对性的干预措施,提高疾病的防治率。本文基于精准医学的视角,对国内外有关2型糖尿病的精准诊断、预测、建档、健康改善、绩效评价模式的应用现状进行综述,以期推动健康管理工作向精准化、个性化发展。     

La psychiatrie de la personne âgée : enjeux et perspectives

Psychiatry in the elderly is a recent branch of psychiatry, born with the increased elderly population, and which tries to be an autonomous discipline in France. European and international Psychiatry in the elderly developed a corpus of knowledge, practices and institutional organizations of its own since 1950s. In France, its current organization is very recent and unequal between regions, so it needs to be clarified and developed. Its teaching has also to be delimited in order to give a better training for different levels of professionals, especially psychiatrists. We will discuss the current situation in France in the light of national and international data and will make hypothesis for development perspectives of its teaching.     

Potentially traumatic events and serious life stressors are prospectively associated with frequency of doctor visits and overnight hospital visits

Objective

Cumulative lifetime exposure to potentially traumatic events and serious life stressors has been linked with both mental and physical health problems; however, less is known about the association between exposure to potentially traumatic events and serious life stressors with health care use. We investigated whether a higher number of potentially traumatic events and serious life stressors were prospectively associated with an increased number of doctor visits and nights spent in the hospital.

Methods

Participants were drawn from the Health and Retirement Study, a prospective and nationally representative study of adults aged 50 + in the United States (n = 7168). We analyzed the data using a generalized linear model with a gamma distribution and log link.

Results

A higher number of potentially traumatic events and serious life stressors were associated with an increased number of doctor visits and nights spent in the hospital. On a 10-point scale, each additional potentially traumatic event or serious life stressor was associated with an 8% increase in doctor visits after controlling for sociodemographic factors (RR = 1.08, 95% CI = 1.06–1.11; p < .001). Each additional potentially traumatic event or serious life stressor was also associated with an 18% increase in the number of nights spent in the hospital after controlling for sociodemographic factors (RR = 1.18, 95% CI = 1.10–1.27; p < .001).

Conclusion

Exposure to potentially traumatic events and serious life stressors is associated with increased doctor visits and nights spent in the hospital, which may have important implications for the current standard of care.