Vulval disease in the postmenopausal patient: a guide to current management

In spite of overwhelming evidence that vulvovaginal symptoms plague up to 46% of menopausal and perimenopausal women, and that there persists a reluctance to seek help among patients, adequate vulval and sexual histories are still woefully rare in general gynaecology clinics. This review aims to present the key points of an effective vulval history and an overview of the accepted current management of vulval disease postmenopause, in order that our patients feel encouraged to present with their problems.     

Dehydroepiandrosterone (DHEA) and the menopause: an update

Since we last reviewed this topic in 2001, considerably more information about dehydroepiandrosterone (DHEA) has accrued, but this has not necessarily left us any wiser about the use of this steroid in postmenopausal women. There is no further evidence that DHEA supplementation is likely to be useful in the prevention of cardiovascular disease or cognitive impairment, or in the promotion of wellbeing. Evidence has, however, accumulated for beneficial effects of DHEA on osteoporosis, both in postmenopausal women and in patients receiving long-term glucocorticoid therapy. What is also emerging is a link between low DHEA levels and cardiovascular risk, and between high DHEA levels and breast cancer risk. In fact, the benefits and adverse effects of DHEA administration in postmenopausal women increasingly resemble those of conventional hormone replacement therapy. Overall, we conclude that DHEA is not currently to be recommended for therapeutic use in the majority of postmenopausal women. However, DHEA supplementation may be of benefit in two specific groups of women: those with the lowest circulating levels of DHEA; and those for whom osteoporosis is a particular problem.     

Elder abuse in Europe: an overview of recent developments

Elder abuse is a global phenomenon. Despite recognition and action several decades ago in a number of countries, in many others the phenomena of abuse and neglect have been much more recently identified as in need of attention. This brief will discuss the situation relating to responses to and interventions in elder abuse that have been evolving in a number of countries in the European region, which are at different stages of development. The examples provided will assist in meeting the worldwide challenge that elder abuse presents.     

Gonadotrophin receptor hormone analogues in combination with add-back therapy: an update

Gonadotrophin receptor hormone analogues (GnRHa) have been used in a range of sex hormone-dependent disorders. In the management of premenstrual syndrome, they can completely abolish symptoms. The success of GnRHa in the treatment of endometriosis and adjuvant therapy in the management of fibroids is proven. This efficacy does not come without a cost and the side-effects of the hypo-estrogenic state have limited their application. The use of add-back therapy to counter these effects has enabled wider application, longer durations of treatment and an increase in compliance. This review article is an update on the evidence supporting gonadotrophin receptor hormone analogues in combination with add-back therapy.     

Market management of the essential economy: an essay

This essay presents a framework for thinking about public economic policy. The argument is that the prevailing theory of competitive markets serves a useful public purpose but creates problems when made into an ideology. The core theory and philosophy suffers from oversights and illusions. Fundamentalist thinking found in it can be dangerous for the long run well-being of humanity. These insights lead to the conclusion that the fundamental task of an economics for public policy should be to develop a theory of workable markets.     

Role of workplace safety: a revisit of the relationship between job satisfaction and employment status

This study evaluated the relationship between employment status (i.e., part- and full-time) and job satisfaction, with the focus on the moderating roles of perceived injury risk and injury incidence. The results found that the level of job satisfaction for full-time workers was about the same regardless of the level of injury risk they perceived. In contrast, job satisfaction of part-time workers was significantly higher when they perceived low injury risk rather than high injury risk. The findings also supported the potential adverse impact of injury incidence and injury risk on job satisfaction for both part- and full-time workers. This study highlighted the importance of understanding both workplace safety and job satisfaction when attempting to understand the differences between part-time and full-time workers.     

Flying through the hospital: efficiency and safety of an ergonomic solution

In hospitals many horizontal transfers (from stretcher to bed etc.) are performed from the moment a patient is admitted (f.e. with an ambulance) through examination departments all the way to the wards. These transfers can be very strenuous and solutions may be to use a special lifting device that accompanies the patient on this route: a stretcher sling This is a specially designed disposable lifting sling for horizontal transfers and repositioning, the sling can easily be connected to a ceiling or mobile lift. The ambulance service, two hospitals and a manufacturer decided to study the effects. The stretcher sling travels with the patient. Does this provide an ergonomically sound solution and is this an effective and efficient solution? The results were positive, but a behavioral change was also necessary.     

The recent history of the IEA: an analysis of IEA Congress presentations since 1961

In this paper we review historical material relating to the growth and coverage of past IEA meetings and congresses. In particular, we report on presentations at IEA Congresses dating back to the first one in Stockholm in 1961. A content analysis of Congress proceedings was carried out and we present findings on changes since 1961 covering: numbers and nationalities of conference participants and the types of topics presented at Congresses. Our findings point to evidence of widening participation at the conferences, in particular delegates drawn from Asia, South East Asia and the Far East. In addition, some topics (e.g., physiology, methodological papers and studies of workload) appear to have waned in popularity over the period, whereas some topics (e.g., ODAM, Cognitive Ergonomics) have grown in popularity. We discuss these findings in the light of other evidence covering historical trends and developments within human factors and ergonomics.     

SafetiPin: an innovative mobile app to collect data on women's safety in Indian cities

Women's safety is a key concern of governments and civil society today. In India, the issue has become prominent in the wake of the gang rape and murder in 2012. One of the key elements in addressing the lack of safety in cities is identifying the causes. SafetiPin, a mobile app, is one tool that has been developed to collect data on safety in cities. Building on the international methodology of safety audits, SafetiPin has transformed it into a mobile app that crowd sources data and information on insecurity in cities. Using SafetiPin, data have been collected in seven Indian cities. This article examines some of the data to understand what factors lead to lack of safety and insecurity in cities, and discusses future plans for the project.     

Estimating the immigration multiplier: an analysis of recent Korean and Filipino immigration to the United States

"This article explores the effect of 'chaining' through the petitioning of relatives on the demand for future immigrant visas [to the United States]. The data for the study come from a 1986 survey of 3,911 respondents from the Philippines and the Republic of Korea who were interviewed in Manila and Seoul just after they had received their U.S. immigrant visas. Analyses are conducted to derive different types of multipliers that may be used in estimating the effects of chain migration.... The empirical results for the Philippines and Korea indicate that the potential for future immigration through the family reunification entitlements of the immigration law is lower than has previously been suggested." This is a revised version of a paper originally presented at the 1987 Annual Meeting of the Population Association of America (see Population Index, Vol. 53, No. 3, Fall 1987, p. 385).     

The management of managers: Disputing in an executive hierarchy

This paper focuses on the relationship between organizational rank and respectability and the way top managers handle their interpersonal grievances, conflicts, and disputes in an executive hierarchy. Formal grievance procedures are rarely used. Downward grievances (from a superior to a subordinate) are often settled unilaterally by the superior. Upward grievances are typically handled covertly by subordinates. Titular equals opt for a range of covert and confrontational tactics, many of which evolve into disputes and are settled by a common superior. Respectability within the executive ranks appears to enhance the ability of superiors to impose outcomes on grievances, conflicts, and disputes between and within subordinates, to decrease the hostility of upward grievances, and to decrease vulnerability of subordinates to sanctions by their superiors.An earlier version of this paper was presented at the Annual Meeting of the Law and Society Association, Washington, DC, June 1987.