Collecting a set of psoriasis family material through a patient organisation; clinical characterisation and presence of additional disorders

BACKGROUND: The aim of the present study was to describe the clinical characteristics of a population of psoriatics sampled from a patient organisation and not from hospitals or out-patient clinics. Furthermore, we wanted to compare siblings with and without psoriasis regarding the occurrence of other diseases. METHODS: At the end of 1991, we initiated a project which aimed to study genetic factors leading to psoriasis. Firstly, we sent questionnaires to all the members of the Swedish Psoriasis Association. We then examined 1,217 individuals (570 with psoriasis) from 310 families, in their homes in the southern part of Sweden. All the available family members were examined clinically and asked about the course of the skin disease and the occurrence of other diseases. The eight hundred members of the proband generation were divided into two groups, with or without psoriasis, and their clinical features were compared. RESULTS: Most individuals in this study population had a mild form of psoriasis. The siblings with psoriasis had joint complaints significantly more frequently than their siblings without the skin disease and those with joint complaints had more widespread skin disease. Among the other studied concomitant diseases (iritis, heart or hypertension disease, endocrine disease, inflammatory bowel disease and neurological disease), we were not able to find any difference. Seventy-seven of 570 persons were found to be in remission (13.5%). Females had a mean onset 2.5 years earlier than males. We were not able to find any correlation between the extent of the skin disease and age at onset. Twice as many persons with joint complaints were found among those with psoriasis than among those without, 28% versus 13%. Almost half (48%) the psoriatics who also had joint complaints had psoriasis lesions on their nails. Endocrine disorders were found in 9% of those without any allele for Cw6, but only in 1% of those who had Cw6. In fact, none of 183 Cw6 carriers had diabetes, as compared to the population prevalence of 3–5% in Sweden. CONCLUSION: With the exception of joint complaints, persons with psoriasis, collected from a patient organisation, did not have an increased frequency of (studied) co-existing diseases

Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study

Abstract Background Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. Methods Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. Results Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. Conclusions Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed

Can biofeedback training in combination with ergonomic information reduce pain among young adult computer users with neck and upper extremity symptoms? : A randomized controlled intervention study

The aim of this randomized controlled study was to explore if an intervention with biofeedback training in combination with ergonomic discussions, could improve working technique and work postures, and reduce pain intensity and perceived exertion in young adult computer users with ongoing neck and upper extremity symptoms. 39 participants were divided into an intervention group and a control group. The intervention consisted of 4 sessions during a three-month period. Working technique, working postures, rated perceived exertion, pain intensity, and duration of computer use were measured at baseline and follow ups after 6 and 12 months. The intervention did not significantly improve working technique and working postures, nor reduce pain intensity and perceived exertion in the intervention group compared to the control group. However, there was a statistically significant reduction in reported pain intensity in the neck/shoulder for the whole group. Also, there was a trend that time spent with computer work without breaks was more reduced in the intervention group than in the control group

Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms.

BACKGROUND: The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. METHODS: At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. RESULTS: The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. CONCLUSION: There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms

Opting to wear prismatic spectacles was associated with reduced neck pain in dental personnel : A longitudinal cohort study

Background: The aim of this study was to investigate effects on perceived exertion, work ability self-reported neck pain and clinically diagnosed conditions in the neck, of an intervention with prismatic spectacles among dental personnel. Methods: In this cohort study a baseline questionnaire including questions about frequency of neck pain, perceived exertion during work and background information was distributed to dental personnel in municipal dental care units. In connection, personnel from 78 out of 110 dental care units underwent a clinical neck examination and rated their perceived work ability with the single-item question from the Work Ability Index. The study population consisted of 564 participants; 366 in the questionnaire group, 321 in the examination group, whereof 123 participated in both assessments. In total 371 belonged to the intervention group and received individually adjusted prismatic spectacles after the baseline assessments (inclusion based on self-selection) and 193 belonged to the reference group. At the 12-month follow-up the clinical examination was repeated and the same questionnaire with additional questions was completed. Fisher's exact test or the Mann-Whitney U test was used to assess differences between the intervention group and the reference group at baseline. Differences at follow up between the two groups were assessed by means of Linear-by Linear association test for trends. Results: A significant decrease in neck pain (p = 0.047), clinical diagnoses in the neck (p = 0.025), and perceived exertion (p = 0.003) was observed at follow up for the intervention group compared to the reference group. Moreover, for the intervention group a significantly improved self-rated work ability (p = 0.040) was reported. Finally, opting to wear prismatic spectacles during dental work appeared to have a preventive effect on neck pain. Conclusions: Dental personnel opting to wear prismatic spectacles reduced their neck pain significantly more at follow up compared with the reference group. These results are worthwhile testing in a randomised design. The practical implication of this study is that recommendations regarding ergonomics for dental professionals may include the use of prismatic glasses, both as primary and secondary prevention of work-related neck pain. Such glasses should also be tested in other working situations where the work tasks include high visual demands in sustained awkward neck postures