Psychosocial risks for low back pain: are these related to work?

Beh?et's disease (BD) is known to be associated with HLA-B51. In order to investigate the influence of the MICB gene, located about 120 kb centromeric of the HLA-B gene, on the susceptibility to BD, (CA/TG) dinucleotide repeat microsatellite polymorphism in intron 1 of the MICB gene was investigated among 77 Japanese patients with BD, 60 randomly selected controls and 28 HLA-B51-positive unrelated healthy controls. There was no significant difference in the phenotype frequency of the microsatellite polymorphism between the BD patients and controls. This result suggests that the MICB gene itself is not responsible for the development of BD, and that the candidate gene(s) for BD is located between the MICA and HLA-C genes.     

The impact of lean production and related new systems of work organization on worker health.

New systems of work organization, such as lean production and total quality management, have been introduced by employers throughout the industrialized world to improve productivity, quality, and profitability. However, few studies have examined the impact of such systems on occupational injuries or illnesses or on job characteristics related to job strain, which has been linked to hypertension and cardiovascular disease. The studies reviewed provide little evidence to support the hypothesis that lean production "empowers" auto workers. In fact, auto industry studies suggest that lean production creates intensified work pace and demands. Increases in decision authority and skill levels are modest or temporary, whereas decision latitude typically remains low. Thus, such work can be considered to have job strain. In jobs with ergonomic stressors, intensification of labor appears to lead to increases in musculoskeletal disorders. The evidence for adverse health effects remains inconclusive for related new work systems in other industries, such as modular manufacturing or patient-focused care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are subjective clinical findings and objective clinical tests related to the motion characteristics of low back pain subjects?

OBJECTIVE: Examine the association between county occupational structure, public expenditures, services availability, prevalence of risk factors, and coronary mortality rates, for 1980-1994, in Washington state. DESIGN: Washington's 39 counties were classified into three occupational structure categories: counties with the lowest percentages of the labor force in managerial, professional, and technical occupations were classified in category I; counties with the highest percentages were in category III. Directly age-adjusted coronary heart disease (CHD) mortality rates, aged 35-64 years, (from vital statistics and Census data), per capita expenditures (Washington Department of Revenue data), per capita services (U.S. Statistical Abstracts data), and the prevalence of CHD risk factors (BRFSS data) were calculated for each occupational structure category. RESULTS: CHD mortality rates and the prevalence of risk factors were inversely associated with occupational structure. Per capita expenditures for health, social, and employment services were 2.2 times, and for schools and recreation were 1.4 times higher in category III vs. I counties. Per capita numbers of child care, job training, employment services, exercise facilities, schools, and medical services were 1.5-6.4 times greater in category III vs. I counties. CONCLUSIONS: Strategies to improve community living conditions and decrease economic disparities between counties may be important to decrease geographic differences in premature CHD mortality.     

Measuring job stressors and studying the health impact of the work environment: an epidemiologic commentary

Time-dependent covariates are often both confounders and intermediate variables. In the presence of such covariates, standard approaches for adjustment for confounding are biased. The method of G-estimation allows for appropriate adjustment. Previous studies applying the G-estimation method have addressed effects on all-cause mortality rather than on specific causes of death. In the present study, a method to adjust for censoring by competing risks is presented. The authors used the approach to estimate the causal effect of isolated systolic hypertension on cardiovascular mortality in the Framingham Heart Study, with a 10-year follow-up using data from 1956 to 1970. Arterial rigidity is a major determinant of isolated systolic hypertension and may be a confounder of the relation between isolated systolic hypertension and cardiovascular death. Conversely, isolated systolic hypertension may by itself contribute to stiffening of the vessel wall, and arterial rigidity may therefore also be an intermediate variable in the causal pathway from isolated systolic hypertension to cardiovascular death. While controlling for arterial rigidity and other baseline and time-dependent covariates, isolated systolic hypertension decreased the time to cardiovascular death by 45% (95% confidence interval 3-69).     

Job involvement and satisfaction as related to mental health and personal time devoted to work.

A week-long daily record and self-report measures of job involvement, satisfaction, and mental health were completed by 54 female elementary school teachers. Results show that devoting personal time to work-related activities was positively associated with job involvement, but unrelated to job satisfaction. Mental health was positively related to job satisfaction, but did not correlate significantly with involvement. These differential relationships support the view that satisfaction and involvement should be thought of as separate and distinct job attitudes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring job stressors and studying the health impact of the work environment: An epidemiolgic commentary.

This article provides a commentary on 5 articles in the special section that marshal a substantial amount of information about 4 instruments for measuring work stress. The perspective is that of psychosocial epidemiology and highlights the differences between the environmental and the psychological traditions of studying stress and health. Several issues are addressed: (a) placing the 4 measures in a broader taxonomy of dimensions of work environment and evaluating the measures in that context, (b) discussing alternative strategies for measuring job strains, (c) analyzing some of the issues in the triviality debate, and (d) reconsidering a number of issues in the ongoing debate about "subjective" versus "objective" measurement approaches to work dimensions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults

STUDY DESIGN: Population-based, cross-sectional, mailed survey. OBJECTIVES: To determine the lifetime, 6-month period, and point prevalence of low back pain and its related disability among Saskatchewan adults and to investigate the presence and strength of selective response bias. SUMMARY OF BACKGROUND DATA: There have been many reports of the prevalence of low back pain in different populations, and the estimates vary widely depending on case definition. However, most studies fail to differentiate between trivial and disabling back pain, which raises the issue of the usefulness of these estimates. No studies have yet documented the prevalence of graded low back pain severity and its related disability in a North American, general, population-based survey. METHODS: The Saskatchewan Health and Back Pain Survey was mailed to a probability sample of 2184 Saskatchewan adults between 20 and 69 years of age. Fifty-five percent of the eligible population responded to the survey. Respondents were compared with nonrespondents, and the presence of selective response bias by back pain status was investigated by wave analysis. The point and lifetime prevalence of low back pain was determined by simple questions, and the 6-month period prevalence of low back pain was determined by the Chronic Pain Questionnaire. All estimates were age standardized to the Saskatchewan population. RESULTS: The authors estimate that at the time of the survey 28.4% (95% confidence interval, 25.6-31.1) of the Saskatchewan adult population were experiencing low back pain, and 84.1% (95% confidence interval, 81.9-86.3) had experienced it during their lifetime. Overall, 48.9% (95% confidence interval, 45.9-52.0) of the population had experienced low intensity/low-disability low back pain in the previous 6 months, 12.3% (95% confidence interval, 10.3-14.4) had experienced high-intensity/low-disability low back pain, and an additional 10.7% (95% confidence interval, 8.8-12.5) had experienced high-disability low back pain in the previous 6 months. There was little variation in the estimates over age groups, but women experienced more high-disability back pain than men. There was no evidence of selective response bias by low back pain status in the survey. CONCLUSION: Low-intensity/low-disability low back pain is a common problem in the general population. Approximately 11% of the adult population studied had been disabled by low back pain in the previous 6 months.     

Reproductive health and work: different experiences

Mesenchymal hamartoma is a rare liver lesion. This lesion was found in a 7-month-old girl with high serum alphafaetoprotein serum levels and was composed of loose connective tissue containing a certain number of epithelial cells of biliary or hepatic origin. Immunohistochemical studies showed that cytokeratins 7 and 19 were localized in bile duct epithelium. The ultrastructural study showed that the hamartoma was composed of well differentiated ductal structures surrounded by a myxoid mesenchyma with cysts formed either from degenerative mesenchymal areas or from dilated ducts. Flow cytometric analysis of nuclei from frozen tissue revealed that the lesion was DNA aneuploid, with a DNA index of 1.28.     

Organizational impact of workaholism: suggestions for researching the negative outcomes of excessive work

Excessive work can be viewed as an addictive behavior, and, as such, it will have a negative impact on the setting in which it occurs, as well as on the individual. This change in perspective is needed to address dysfunctional behavior patterns that interfere with organizational operations. Similarities with other addictions include identity issues, rigid thinking, withdrawal, progressive involvement, and denial. These factors influence decision making and goals of the workaholic. They also interfere with effectiveness by distorting interpersonal relations. Suggestions for further research build on established organizational topics that coincide with characteristics of an addictive pattern.     

Emotional impact of multiple sclerosis: Recent findings and suggestions for future research.

Multiple sclerosis (MS) is believed to impose a severely deleterious emotional impact on patients and their families. A review of the recent research literature indicates that few controlled investigations have been done to support the assumption. Recent data have indicated that two factors—functional loss (imposed by the increased physical disability produced by MS) and disease activity (exacerbation and progression of symptoms)—have been identified as contributors to increased emotional distress in MS patients. However, theoretical formulations concerning the specific mechanisms by which these or other potential determinants may produce emotional distress appear, largely, to have been ignored. Thus, this article identifies a number of fundamental conceptual and methodological issues. Potential solutions for the problems that they introduce are suggested, and a provisional model of the mechanisms involved is offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perception of traumatic onset, compensation status, and physical findings: impact on pain severity, emotional distress, and disability in chronic pain patients

The primary purposes of the present study were to investigate the roles of physical findings, financial compensation, and types of pain onset (i.e., trauma vs. insidious onset) on adaptation by chronic pain patients. Comparisons between patients who were receiving or seeking compensation and those who were not revealed that, despite comparable degrees of physical findings, the compensation status was associated with reports of (a) more severe pain, (b) greater disability, (c) higher levels of emotional distress, and (d) greater life interference. The compensation status of 74% of the patients was correctly classified by combination of pain severity, perceived disability, and life interference. Objective indices of physical findings did not significantly improve classification accuracy. In order to eliminate the possible confound of compensation, analyses of the relationship between the types of onset and chronic pain were conducted only for a subset of patients who were not receiving or actively seeking compensation. The results indicated that the patients who attributed their pain to a specific trauma reported significantly higher levels of emotional distress, life interference, and higher levels of pain severity than did the patients who indicated that their pain had an insidious or spontaneous onset, regardless of the extent of objective physical findings.     

Cognitive arithmetic and problem solving: a comparison of children with specific and general mathematics difficulties

This study examined problem-solving and number-fact skills in two subgroups of third-grade children with mathematics difficulties (MD): MD-specific (n = 12) and MD-general (n = 12). The MD-specific group had difficulties in mathematics but not in reading, and the MD-general group had difficulties in reading as well as in mathematics. A comparison group of nonimpaired children (n = 24) also was included. The findings showed that on both story and number-fact problems, the MD-specific group performed worse than the nonimpaired group in timed conditions but not in untimed conditions. The MD-general group, on the other hand, performed worse than the nonimpaired group, regardless of whether tasks were timed or not. An analysis of children's strategies in untimed conditions showed that both the MD-specific and the MD-general groups relied more on backup strategies than the nonimpaired group. However, children in the MD-specific group executed backup strategies more skillfully than children in the MD-general group, allowing them to achieve parity with children in the nonimpaired group when tasks were not timed. The findings suggest that children with specific MD have circumscribed deficits associated with fact retrieval, whereas children with general MD have more basic delays associated with problem conceptualization and execution of calculation procedures.     

Building community health: the real work of advanced practice

The future of health care depends on how well health professions join in partnership with community leadership. The challenge that lies ahead for nursing is to become fully invested in the process of building truly healthy communities.     

Trends in health and ability to work among the older working-age population

OBJECTIVES: Because of recent changes in Social Security regulations that will soon begin to raise the age of eligibility for full retirement benefits, it is important to determine whether health and ability to work at older ages have improved in recent years. METHODS: Individual-level data from the National Health Interview Survey from 1982 through 1993 are used in this analysis. Trends in self-reported ability to work, presence of disease, and causes of actual work limitation are examined. RESULTS: Men and women in their 60s, that is those in the older working ages and younger retirement ages, report significant improvement in their ability to work. The change in work ability is large enough so the percentage unable to work at age 67 in 1993 is lower than the percentage unable to work at age 65 in 1982. This improvement appears to have been similar for racial and ethnic groups and across educational subgroups of the population, although African Americans and those with lower educational attainment are less healthy to begin with. The improvement in health is due to the changing educational composition of the population, which is linked to better life-long health, different occupational circumstances, and better health behaviors. In addition, the improvement in work ability is explained by decline in the prevalence of cerebro/cardiovascular diseases and arthritis. DISCUSSION: The level of observed improvement in work ability means that the legislated rise in age of full eligibility for Social Security benefits should be more than compensated for by the improved ability to work.     

Practicing psychologists' knowledge of general psychotherapy research findings: Implications for science-practice relations.

If you are a therapist, how knowledgeable are you and how knowledgeable do you need to be about psychotherapy research findings? In this study, the authors examined practicing psychologists' knowledge of general psychotherapy research findings. Results revealed that some psychologists showed excellent familiarity with this body of outcome research, but many did not achieve this standard. Not infrequently, psychologists believed that research findings were less positive than is actually the case, perhaps explaining some of the negativity that practitioners sometimes express toward psychotherapy research. Research knowledge could not be predicted by years graduated, percentage of long-term clients, percentage of time conducting therapy, theoretical orientation, or perceived familiarity with research. The modest familiarity with research findings that therapists, in general, demonstrated may be understood, in part, through examination of the acquisition of research knowledge as a judgment task. The authors explore potential factors that may influence therapists' judgments about the research. In addition, they examine possible relations between research knowledge and therapy outcome and their potential practice implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)