Opinion paper: the role of work in the management of medically unexplained physical symptoms

OBJECTIVES: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms. METHODS: In this paper, different actors involved explain their views and handling concerning work in the management of MUPS. RESULTS: Symptom severity and lack of understanding from the environment can negatively impact on earning an independent income from labor for years. Work, whether or not paid, is however, an important life domain with positive effects on physical, psychological, and social well-being. Therefore, health actors are pivotal in starting the professional reintegration process as soon as possible and should discuss this item from the early stage onward. Support services can be consulted in mutual interaction as required. A case manager, acting as a central intermediator within this multidisciplinary approach, may promote effective communication and coordination between the patients and their surrounding actors. CONCLUSION: The professional reintegration process should start as soon as possible within the management of medically unexplained physical symptoms. As such, the care sector, the evaluation sector, and the professional integration sector should collaborate and effectively communicate with each other.status: publishe

Opinion paper: the role of work in the management of medically unexplained physical symptoms

Objectives: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms. Methods: In this paper, different actors involved explain their views and handling concerning work in the management of MUPS. Results: Symptom severity and lack of understanding from the environment can negatively impact on earning an independent income from labor for years. Work, whether or not paid, is however, an important life domain with positive effects on physical, psychological, and social well-being. Therefore, health actors are pivotal in starting the professional reintegration process as soon as possible and should discuss this item from the early stage onward. Support services can be consulted in mutual interaction as required. A case manager, acting as a central intermediator within this multidisciplinary approach, may promote effective communication and coordination between the patients and their surrounding actors. Conclusion: The professional reintegration process should start as soon as possible within the management of medically unexplained physical symptoms. As such, the care sector, the evaluation sector, and the professional integration sector should collaborate and effectively communicate with each other

Anaerobes in Bioelectrochemical Systems

In bioelectrochemical systems (BES), the catalytic activity of anaerobic microorganisms generates electrons at the anode which can be used, for example, for the production of electricity or chemical compounds. BES can be used for various purposes, including wastewater treatment, production of electricity, fuels and chemicals, biosensors, bioremediation, and desalination. Electrochemically active microorganisms are widely present in the environment and they can be found, in sediment, soil, compost, wastewaters and their treatment plants. Exoelectrogens are microorganisms capable of donating electrons to anode electrode or accepting electrons from cathode electrode and are mainly responsible for current generation or use in BES. However, current generation from fermentable substrates often requires the presence of electrochemically inactive microorganisms that break down complex substrates into metabolites which can be further utilized by exoelectrogens. The growth and electron transfer efficiency of anaerobes depend on several parameters, such as system architecture, electrode material and porosity, electrode potential and external resistance, pH, temperature, substrate concentration, organic loading rate, and ionic strength. In this chapter, the principles and microbiology of bioelectrochemical systems as well as selective factors for exoelectrogens are reviewed. The anaerobic microorganisms and their electron transfer mechanisms at the anode and cathode are described and future aspects are briefly discussed.acceptedVersionNon peer reviewe