Physicians' role in patient ergonomics: a pilot study

With the ever-increasing rate of the integration of technology, and office workers making up the largest single sector of occupations, many workers are spending an increasingly large portion of their work time in the prolonged sitting or standing position and while on computer-based systems. Evidence-based research suggests that increased sedentary time is associated with diabetes, hypertension and other mortality causing diseases such as cardiovascular disease. There is a lack of occupational medicine considerations, specifically ergonomics, incorporated into the patient plan of care in the primary care setting. This is likely due to the decreased number of physicians specializing in occupational medicine (OM), and the lack of OM education in medical school curriculum. The current time constraints of the medical system may make the integration of additional screening seem unreasonable. With the introduction of occupational therapy as a contributing member of the primary care team, the burden of ergonomic training and education for at-risk patients can be reduced. Through participation in the Physicians’ Role in Patient Ergonomics workshop, a 20-minute online video aimed at explaining the connection between occupational risks and common health issues seen in the primary care setting, physicians can learn about the implications of occupational risks on patient health, and how to utilize brief screening questions and decision trees to efficiently determine which patients may benefit from ergonomic education and training

Uneven focal shoe deterioration in Tourette syndrome.

A 31-year-old single man (AB) sought neuropsychiatric consultation for treatment-resistant motor and vocal tics. He described himself expressing a total of 24 different tics, mainly facial twitches (eye blinking, raising eyebrows, mouth opening, lips licking, stereotyped grimacing) and inappropriate utterances (grunting, throat clearing, sniffing), since the age of 7. There appeared to be no family history of tic disorder. He reported occasional utterance of swear words in contextually inappropriate situations (coprolalia), and the urge to copy other people’s movements (echopraxia). Other tic-associated symptoms included self-injurious behaviours and forced touching of objects. A.B. met both DSM-IV-tr and ICD-10 criteria for Tourette syndrome, and also DSM-IV-tr criteria for attention deficit hyperactivity disorder (combined type) in childhood