The “Aging Males’ Symptoms” Scale (AMS): predictive value for lowered circulating androgens

Background: Symptoms of the “male climacteric” are often at least in part referred to an age-dependent decline of serum androgen levels. Therefore, we evaluated the relationship of climacteric symptoms as assessed by the “Aging Males’ Symptoms” (AMS) Questionnaire with circulating androgen levels. Methods: 146 ambulatory men (age, 27–85 years) were surveyed with the AMS Questionnaire and sampled for serum values of total testosterone (tT) and sexual hormone binding globulin (SHBG). Free testosterone (fT) was calculated from tT and SHBG. A total AMS score ≥37 was considered pathological; the lower limits for tT and fT were set to 8 nmol/l and 180 pmol/l, respectively. Results: A significant deficit in tT and fT was shown in 25 (17.1%) and 34 (24.5%) men, respectively; the AMS Questionnaire showed pathological results for 66 (45.2%) men. In predicting a tT deficit, the AMS Questionnaire rendered a sensitivity of 76% and a specificity of 61.6%, only. However, multiple regression analysis revealed a significant correlation of lowered tT with a pathological somatovegetative and psychological AMS subscore (p = 0.042 and p = 0.01) and a correlation of lowered fT with a pathological sexual subscore (p = 0.039). Conclusion: In predicting hypogonadism the AMS Questionnaire in total did not render a sufficient diagnostic efficiency.     

Importance of active listening in treating workers with musculoskeletal disorders

Female assembly workers reporting constant neck and shoulder pain, despite ergonomically acceptable working conditions, were interviewed. As a starting point in the interviews, the patients were asked to describe their general situation at work. Their reports were fed back and discussed with company management in a wider group meeting and resulted in an improvement in their attitudes to those workers. A climate of confidence and well-being was created, which the women experienced as genuine. The workers' report of pains improved dramatically and absence due to musculoskeletal disorders was reduced by more than 90% during the following year.     

Importance of active listening in treating workers with musculoskeletal disorders

Abstract

Female assembly workers reporting constant neck and shoulder pain, despite ergonomically acceptable working conditions, were interviewed. As a starting point in the interviews, the patients were asked to describe their general situation at work. Their reports were fed back and discussed with company management in a wider group meeting and resulted in an improvement in their attitudes to those workers. A climate of confidence and well-being was created, which the women experienced as genuine. The workers' report of pains improved dramatically and absence due to musculoskeletal disorders was reduced by more than 90% during the following year.     

Qualitative insights into women's personal experiences of perinatal depression and anxiety

Background and aimSymptoms of perinatal depression and anxiety are usually described and understood from a nosological perspective. This research sought to gain insight into women's lived experience of postnatal depression and anxiety, the factors that contribute to these symptoms and the context in which they develop.MethodFace to face and telephone interviews were conducted with 28 women from metropolitan and rural areas across Australia, who had experienced postnatal depression and/or anxiety within the last five years. Analysis was conducted from a grounded theory perspective.FindingsParticular symptoms of anxiety and depression develop in the context of the numerous changes inherent to the transition to motherhood and contribute to a common experience of frustration and loss. Symptoms were also associated with feelings of dissatisfaction with the pregnancy and motherhood experience.ConclusionsThe findings provide useful insights into women's experiences of mental health symptoms during the perinatal period, how these symptoms present and the factors involved in their development and maintenance. The need to consider women's perspectives to develop resources and health promotions strategies, as well as within the context of relationships with health professionals is highlighted. The study emphasizes the need for greater, more accurate information surrounding perinatal depression and the need to increase the profile and awareness of anxiety disorders.     

Musculoskeletal problems in bricklayers as a function of length of employment: The role of secondary selection by low-back pain

Abstract

Low-back problems that are caused by heavy physical work should increase with the length of employment. In a cross-sectional study 195 bricklayers were interviewed and subjected to a medical examination concerned with complaints and functional impairments of the musculoskeletal systems of different body regions (neck/shoulder, arms/hands, back, hip/legs/feet). Summary variables for complaints and impairments indicated an increase with increasing age. Contrary to expectation, in pairs of bricklayers of the same age, but different length of employment, a general decline of complaints and impairments with longer employment was observed. This finding suggested a healthy worker effect. In a follow-up the turnover rate among 190 of the 195 bricklayers of the original study was determined. Bricklayers who had quit the job had a higher incidence of low-back troubles before leaving than bricklayers who had stayed in the job; the relation between turnover and low-back problems was limited to bricklayers older than about 40 years.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Modification of shiftwork effects by chemical workplace exposure

Abstract

Possible chronotoxic effects were the reason to study chemical workplace exposure under the special condition of shiftwork. Eight shiftworkers occupationally exposed to acetone vapours and eight controls were investigated during fast-rotated shiftwork. The mean concentration of acetone during the shifts was close to 1000 ppm (2400 mg/m³). Data on well-being and acute symptoms, but not on performance, indicate that the exposure contributed mainly in an additive way to the negative effects of shiftwork. As a consequence, the exposed shiftworkers revealed enhanced impairments during the night-shift.     

How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Treatment with human chorionic gonadotropin for PADAM: A preliminary report

The purpose of this study was to evaluate the efficacy and safety of human chorionic gonadotropin (hCG) for patients with partial androgen deficiency of the aging male (PADAM). Twenty-one patients over 50 years of age with PADAM symptoms were included in this study. Laboratory and endocrinologic profiles were reviewed as appropriate, and PADAM symptoms were judged by means of several questionnaires such as the Aging Males' Symptoms (AMS) scale, short version of the International Index of Erectile Function (IIEF-5), and the Self-rating Depression Scale (SDS). Laboratory and endocrinologic values and symptom scores were evaluated and compared before and after treatment by hCG injection. The treatment period was 8.0 ± 5.0 months (3.0 – 24.0 months). Serum concentrations of testosterone, including total testosterone, calculated free testosterone, and calculated bioavailable testosterone, increased significantly. AMS total scores and subscores decreased significantly after treatment. However, IIEF-5 and SDS scores did not improve. With respect to adverse effects, laboratory tests showed that only red blood cell count, hematocrit and hemoglobin level increased significantly after treatment, however, these values remained within the normal range. No adverse effect was identified after treatment. We conclude that hCG injection may be considered as a treatment for PADAM.     

The validity of the occupational stress indicator

During the last two decades two potent groups of predictors for work-related musculoskeletal problems have been identified: physical work load and poor psychosocial working conditions. However, little is known about their combined effects. In this study the buffering effect of control at work with respect to the negative effects of psychological demands and physical work load on musculoskeletal problems is examined. All study variables were sampled from 431 people working in geriatric nursing homes in Germany by means of questionnaires. Main effects and interactions were tested with multiple regression analysis. The results showed that control buffered the effects of high psychological demands, but not of high physical work load; the buffering effect of control was observed only when physical work load was low. The combined effects of demands and physical work load were over-additive. Thus, the power of different predictors for musculoskeletal symptoms depended on the level of other predictors. This suggests that the efficiency of certain strategies for the prevention of musculoskeletal problems is likely to depend on the level of risk factors, with different strategies being appropriate for different levels of risk.