A recent cross-sectional study  reported that in- creased physical activity was associated with improve- ments in some metabolic and inflammatory markers of health . On the other hand, increasing research ef- fort has been focused on the role of insulin resistance in age-related conditions or geriatric syndromes, such as musculoskeletal morbidities. Based on a population- based National Health and Nutrition Examination Survey (NHANES), Kuo et al.  reported an inverse association between insulin resistance and habitual gait speed in non-diabetic older men (≥50 years), suggesting insulin resistance is an important indicator of gait func- tion among men. Further, Kalyani et al.  reported that elevated fasting glucose level was associated with lower grip strength in older men, but not in women without self-reported diabetes and/or use of diabetes medication. Zhang et al.  also reported that poor lower extremity function was associated with pre- diabetes/diabetes in older Chinese. However, little is known the correlations between inflammatory and meta- bolic markers and musculoskeletal health-related param- eters including hand grip strength, musculoskeletal discomfort, and gait disturbance in a rural setting, and the differences of such correlations due to gender differ- ence. Such information would provide a base for future nutritional advice and life style education to manage musculoskeletal health in a rural population. Therefore, the current study investigated the factors affecting musculoskeletal health in terms of hand grip strength, musculoskeletal discomfort, and gait disturbance for dif- ferent genders. We focused on a rural West Texas mul- tiethnic adult and elderly cohort using data collected through the Project FRONTIER (Facing Rural Obstacles to healthcare Now Through Intervention, Education & Research) to explore the natural course of chronic
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Socio-demographics and physical health-related fitness characteristics were collected at baseline and included information on sex, age, education, smoking/drinking status, marital status, income and chronic conditions. Weekly PA, based on the CPAFLA Healthy Physical Ac- tivity Participation that examines frequency, intensity and perceived fitness, - and previous lifetime TC partici- pation of more than one year, were also recorded . Pre- and post-TC program musculoskeletal health- related fitness characteristic testing was conducted by qualified exercise personnel and were assessed pre- and post-TC program by employing a combination of the Canadian Physical Activity Fitness and Lifestyle Ap- proach and the Senior Fitness Test [12,19]. These mea- sures included anthropometrics (height and weight which was used to calculate body mass index), upper body (overall grip strength, arm curl test in 30 seconds), lower body (chair stand test in 30 seconds, timed 8-foot up and go test) and lower back flexibility measure (sit- and-reach). Height was measured using a wall mounted tape measure without footwear, standing erect, arms hanging by the sides with feet together, the heels and back in contact with the wall using a set square the measure was made to the nearest 0.5 cm. Weight was measured using a calibrated scale on a wooden surface with the participant wearing light clothing, the weight in
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Gait analysis can be used as a biofeedback marker of musculoskeletal health as it provides physical functional outcome measures to quantify improvement, monitor treatment and can provide early diagnosis of mechanical compensation due to patient pain or discomfort. Diverse gait-analysis technologies have been developed and used in humans and sport horses over the past 40 years, and are constantly being refined to provide reliable measures of improvement from disease . Current technologies include wearables, inertial measurement units or acceler- ometers which are lightweight, wireless devices to investi- gate activity levels, gait patterns and fitness parameters for humans and other animals [98–100]. Real-time or delayed-time parameters that can be analysed include ground reaction forces and foot-pressure distribution, the kinematics of joints and segments, along with dynamic electromyograms . The information gained from these analyses enables clinicians to quantify, and therefore monitor and evaluate, gait and posture pa- rameters such as asymmetry and other abnormal movement patterns, possibly indicating pain or dis- comfort in the musculoskeletal system. Increasing evi- dence indicates that cytokines and mediators together with mechanical stress are key to the development of cartilage damage; this mechanical stress due to abnor- mal movement patterns can also be quantified by gait analyses . Gait analysis has great clinical value as a test for patients with neurological and orthopaedic disorders as it provides quantifiable, objective, data to aid the clinician in selection of any surgical procedure needed and then to monitor outcomes and follow up post-surgery. This is a valuable addition to the use of traditional clinical examination. Nowadays, more ac- curate and user-friendly technology for gait analysis allows investigation of musculoskeletal diseases in hu- man patients  and other species, with the goal of obtaining a better definition of specific clinical hall- marks of diseases such as rheumatoid arthritis  and OA [103–105].
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been observed during all client-related activities . Results from kinematic posture analysis revealed that hairdressers spend 9–13% of their total working time with arms elevated over 60° [7, 8]. Working with elevated arms above shoulder level is considered a major risk factor for clinically verified shoulder disorders or persistent severe pain [9, 10]. The rela- tively high force exertion and wrist velocity – combined with prolonged exposure – may account for the higher rate of hand/wrist pain, especially in female hairdressers . In a study on the working conditions of Finnish hairdressers, the most hazardous factors for health were repetitive move- ments, awkward working postures, standing, uncomfortable temperatures and chemicals. The same factors – in addition to mental stress – were reported to cause work-related ill- nesses . According to three health insurance companies with 51,842 hairdressers in Germany, MSD was the main reason for sick leave, within the range of 16 to 21% of the total . Compared to other occupational groups, hair- dressers complain significantly more frequently about MSD in different body regions [13, 14]. Studies indicate that hair- dressers give up their profession mainly for health reasons. The most frequently cited reasons are complaints of the musculoskeletal system [15 – 17].
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Chiropractic is an emerging profession with an evolving role in musculoskeletal health, particularly regarding patient assessment and musculoskeletal care. Concurrently, the WA Department of Health is actively planning future services by exploring innovative ways to provide for the health care needs of the population, using the Health Networks as a vehicle. Of relevance is the Musculoskeletal Health Network that focuses on various musculoskeletal issues, like spinal pain and chronic disease, with a view to inform future healthcare planning and services. In line with the Musculoskeletal Health Network’s models of care, the chiropractic profession in WA is actively exploring pioneering roles with a view to contribute to the mainstream health care system and service provision. An example of this is the chiropractic care provided to residents at Palmerston Farm in Perth, a novel service to people affected by substance use, by supervised chiropractic Interns from Murdoch University. Although this type of community outreach is not original, this project represents a fresh,
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The Literacy in Musculoskeletal Problems (LiMP) questionnaire was developed to evaluate the “...compe- tencies that are integral to making informed decisions regarding musculoskeletal health” (p. 610) . The LiMP consists of 9 items across three domains: anatomy and terminology, musculoskeletal conditions, and diag- nosis and treatment. The questionnaire takes 5 min to complete. Patients are asked to select a response for each item (5 response options for items 1–8 and 4 re- sponse options for item 9) and only one response is per- missible. The response to each item is scored as correct (1) or incorrect (0) and the score totalled for a possible score of 9. LiMP scores below 6 are reported to indicate limited musculoskeletal HL and “…scores of ≥6 can ef- fectively rule out both limited musculoskeletal literacy and general health literacy ” (p. 191) . The LiMP has been used to evaluate the musculoskeletal HL of those with carpal tunnel syndrome , foot and ankle com- plaints , those presenting to an emergency depart- ment [14, 17] and an orthopaedic outpatients clinic . It has a Flesch-Kincaid grade level of 4.2 (able to be read by those with a 4th grade education or above) .
health complaints . We have earlier, in a similar Norwegian sample, shown that FABW were the stron- gest predictor for non-RTW at 3 and 12 months follow- up of WR participants . The assessment of fear avoidance beliefs was originally based on a biopsychoso- cial model . Fear avoidance beliefs are mediators be- tween pain and avoidance behavior, such as sick leave and withdrawal from working life [31, 32]. Pain and avoidance behavior is determined by psychological processes in experience and interpretation of pain and discomfort [33, 34], and comprises sensory as well as cognitive, affective, behavioral, and social aspects [30, 35]. The meaning of pain to the individual depends on how the pain stimulus is evaluated, the expected out- come, based on previous experiences, and whether the in- dividual expects to cope with the pain or not . The Cognitive activation theory of stress (CATS) postulates that learned stimulus and response outcome expectancies determine psychobiological responses . Individuals expecting to cope with a specific situation have established positive response outcome expectancy, while individuals who do not expect to cope may have negative response outcome expectancies (hopelessness) or no response out- come expectancies (helplessness) . In the current study we propose and test five paths, and hypothesize that FABW will mediate the effects of subjective health com- plaints (musculoskeletal and pseudoneurological com- plaints), functional ability (poor coping/interaction ability, poor lifting/carrying ability and poor moving ability), and education on days on sickness benefits after WR (Fig. 1). We also hypothesized that high levels of earlier sick leave will lead to high levels after the intervention.
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contribute to the elevated health expenditures and crash risk is unclear. Absenteeism and job change is related to crash risk  although it is not clear what led to absenteeism or job change, and whether other factors may have influenced crash risk. MSDs, stress, diabetes, hearing and vision impairments and sleep disorders, can all impair driving safety. Truck drivers are subjected to various chemical hazards such as skin reactions and chemical burns, headaches, nausea, dizziness (especially in gasoline tanker trucks), and lung cancer from inhaling diesel exhaust .
We have omitted the level “intermediate downsizing” from tables 3–5 because this information is redundant in supporting our conclusions. As the comparison between mod- els 1 and 2 in table 3 shows, additional adjust- ment for physical demands after downsizing attenuated the association between downsizing and severe musculoskeletal pain in all groups. This indicates that increases in physical demands may partially underlie the associ- ation. Attenuation was 59% in men and 24%– 36% in other groups. Adjustment for covariates of skill discretion and job insecurity attenuated the association in women and low income employees. Simultaneous adjustment for all Table 1 E V ect of downsizing on musculoskeletal problems adjusted for age, sex, and
GIS have a wide range of tools for the spatial structure of healthcare facilities and the monitoring of access to health services (Mc Lafferty, 2003; Fradelos et al., 2014). The use of GIS is useful for understanding health problems in diverse geographical areas (dos Anjos and Cabral, 2016). GIS technologies can contribute to the research and development of health policies through rational decision making, since they allow for the spatial linking of different types of entities such as physical objects, regional units, demographic information, geographical distribution of economic resources, population, and other relevant factors (Bellander et al., 2001; Mennecke and Lawrence, 2001; Tanser and le Sueur, 2002).
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Throughout the intervention period (1 to 2 years, depend- ing on when the nursing home steps into the intervention) initiatives will be made to motivate and engage partici- pants. First, the concepts of the project are participatory to ensure that the intervention is tailored to the specific needs of the participants (expecting that needs change over time), facilitating ownership and motivation to sus- tain the initiatives. Regular meetings of the entire organization will ensure that all are informed about the main features, purposes and processes of the project. The researchers will encourage health and work environment issues to be on the agenda in multiple settings (e.g. at staff meetings, in the team coordination) and continually facili- tate initiatives to remind the supervisors and employees about the key messages. This will for example be done through special events at the workplace and organizing theme weeks using posters and roll-ups at the workplace. Furthermore there is a booster session, a course of 3 h approximately every half year for both management and employees. These courses both have the purpose of following-up on the topics from the last course, to handle challenges currently at the workplace, and to prepare new employees to engage in the dialogue.
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Daily exposure to vibration. From the analysis conducted for the data obtained from the WBV instrument, Figure 1 shows all LRT have daily exposure value more than exposure limit value (1.15 m/s 2 ). The daily exposure limit value is the maximum amount of vibration an employee may be exposed in single day. In this situation the LRT that contain A(8) value more than 1.15 m/s 2 the employer must take action by reduce exposure to vibration to below the limit value because it may lead to increase health risk to LRT drivers.
Among the economic cost, medical care costs paid by insurer were estimated using NHIC statistics for the year 2008 . Additionally, copayment costs and non- covered care costs were estimated using the first round of the 2008 Korea Health Panel data and were estimated as patient costs. OTC drugs costs and other costs such as medical equipment costs were also estimated using the first round of the 2008 Korea Health Panel data. In the breakdown of direct non-medical costs, transporta- tion costs were estimated using the first round of the 2008 Korea Health Panel data, and caregiver costs were estimated from NHIC statistics. Indirect costs were composed of premature death costs and productivity losses due to hospital admission and outpatient visits. The total numbers of admission days were acquired from NHIC statistics, and the number of outpatient vis- its was estimated from the Korea Health Panel data. Cause of death data as reported by the National Statisti- cal Office (NSO) in 2008 were used to estimate the cost of premature death. Likewise, the total population figure used in this study was the NSO ’ s estimated population for 2008 . All measured costs were calculated in US dollars (1$ = 1104.7 won) .
limb and foot), and if their MSD is experienced con- stantly or not with the options never, rarely or always. The protocol also contains a question about estimated workload in the respondent’s previous occupation, with the response options light/easy or heavy/hard. An add- itional five questions concerned perceived self-rated health, i.e. how the respondent experienced their phys- ical body, mental health, social environment, physical environment and work ability. The response options were categorized as bad, good and excellent [5, 12, 15]. Both content and predictive validity of the protocol had been established [5, 12].
One possible solution to increase osteoporosis aware- ness among clinicians is through provider education programs. Such programs have been shown to improve clinician knowledge and clinical practice in other clinical areas. For example, a recent randomized trial of a phys- ician education program for asthma designed to improve therapeutic and communication skills found that the patients whose primary care physician had attended the training program had fewer symptomatic days and fewer asthma-related emergency department visits . How- ever, there have been relatively few published descrip- tions of structured educational programs for health care providers or trainees in the area of musculoskeletal (MSK) care.
Comorbid mental health problems in RA are associated with worse patient outcomes. Several studies have re- ported that poorer mental health associates with higher levels of DAS28-defined disease activity, although this appears to be driven by its relationship with the “subjective” components of the DAS28 (the tender joint count (TJC) and patient global assessment of disease activity (PtGA)). Matcham et al.. performed a secondary analysis of the CARDERA trial, reporting that the pres- ence of persistent depression and anxiety associated with higher DAS28 scores over time; exploring relationships with the individual DAS28-components revealed the association was restricted to the TJC and PtGA, with no significant association seen between depression and anxiety and the swollen joint count (SJC) and erythrocyte sedimentation rate (ESR) . Similarly, Cordingley et al. reported a significant association between the PtGA and the Hospital Anxiety and Depression Scale (HADS) depression score in 322 RA patients awaiting biologic therapy, but not the other DAS28 compo- nents .
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The prevalence of chronic musculoskeletal ankle disor- ders was high, as reported in other countries. Therefore these results can be used to stress to the general public and health care professionals, not to consider these problems a minor priority. Awareness programmes at school/club/society levels, may be effective in treating the initial injury and reducing chronicity in the Sri Lankan community. Not only awareness of rehabilitation services such as physiotherapy, but also the acute re- habilitation process including the RICE protocol, basic stretching and strengthening exercises, should be raised among the general public and health care professionals.
Normally employees are using the computer for more hours continuously. People at the age above 41 are affected more so they should take more care about their health. Young people are affected more in the next level. This analysis shows that only half of the affected people are taking treatment others not taking care about their fact. Female category people affected more compare with male category. Employees working in bank, railways are using computers for long time. Musculoskeletal disorder will come for the persons who work computers for long time. If the computer users follow the given suggestions they will avoid the problems completely.
Our study population included a young adult working popu- lation mainly, but their health behaviors are risky. When compared to the ﬁ ndings of a prospective cohort study in the Thai rural community of similar socioeconomic charac- teristics which was conducted from 2008 – 2015, percentages of current smokers and prehypertension are higher in our participants than Thai adults in that study. (26.3% vs 20.82% and 44.7% vs 29.39% respectively). 27 The mean duration of smoking in the study participants is about 8.00 ±8.52 years. But, about 40.8% of current drinkers in this study are lower than 44.13% in that cohort study and spirits is the most common type of alcohol in this population. The pre- valence of hypertension and insuf ﬁ cient physical activity is also lower than Thai adults in the rural community (28.93% vs 27.1% and 77.28% vs 75.8%, respectively). However, the prevalence of smoking, alcohol drinking and physical inac- tivity is quite high compared to another study of Myanmar youth workers in Samut Sakhon (Central Thailand) in 2000 (21.5% current smokers, 25.4% alcohol drinkers, and 36.7% physical inactivity). 28 Their health behaviors are riskier than that of their host and native countries. 4,29,30 Although their lifestyles are risky, their knowledge about the healthcare system is poor. About 34.3% of participants do not know the migrant health insurance scheme (30 baht scheme) for registered migrants provided by the Thai government, which is higher than 10% in IOM report 2015. 31
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domains of physical and emotional health, grouped into 2 single and 11 multi-item scales that use a Likert-type scaling mechanism to measure poor to good health (see Table 1). Two additional single items are contained within the multi-item scales and can be used to represent an independent concept of Global General Be- havior and Global General Health (GGH). Each multi-item scale score is calculated by totaling contributions from each item and then scaling the total score to provide values from 0 (representing worst health) to 100 (representing best health). The single GGH item was used in addition to the complete CHQ to measure parental perception of their child’s global health. Used in its entirety, the CHQ provides scales that encompass functioning, social roles, emotional health, physical health, and family func- tioning (activities and cohesion).