Association of perceived work pace and physical work demands with occupational accidents: a cross-sectional study of ageing male construction workers in Denmark

Background Occupational accidents continue to be a significant public health challenge worldwide. Construction workers in particular are at high risk of occupational accidents, and thus it is of major importance to identify possible predictors of occupational accidents among construction workers. We aimed to investigate the association between self-reported work pace and physical work demands and occupational accidents among ageing male construction workers in Denmark. Methods Data on perceived work pace, physical work demands, and occupational accidents was acquired from questionnaires sent to ageing construction workers in Denmark in 2016 as part of the ALFA project (ALdring og Fysisk Arbejde; Ageing and Physical Work). A sample of 1270 Danish male construction workers above 50 years of age was included in the present study. Multiple logistic regression models were applied, with adjustments for age, smoking, body mass index, musculoskeletal disorders, occupation, work experience, and support at work. Results Of 1270 construction workers, 166 (13.1%) reported an occupational accident within the last 12 months. There was no significant association between perceived work pace and occupational accidents, but physical work demands were associated with higher odds for occupational accidents, with an odds ratio of 2.27 (95% confidence interval 1.26–4.10) for medium physical work demands and 2.62 (95% confidence interval 1.50–4.57) for high physical work demands. Conclusions Ageing male construction workers with high physical work demands had statistically significant higher odds of having an occupational accident. By contrast, perceived work pace was not associated with occupational accidents in this large cross-sectional study.

Urology

This chapter explores urology, starting with the symptoms and signs. Symptoms in urology include pain, haematuria, urinary incontinence, male sexual dysfunction, haemotospermia, and lower urinary tract symptoms. Lower urinary tract symptoms refer to a group of symptoms that typically affect the ageing male. It is often caused by bladder outflow obstruction (BOO) related to prostatic enlargement and includes symptoms related to both voiding and storage. The chapter then looks at the investigations of urinary tract disease, detailing laboratory investigations, radiology investigations, and endoscopy. It deals with urinary tract stones; obstruction of the ureter; benign prostatic hyperplasia; stricture of the urethra; scrotal swellings; disorders of the foreskin; common conditions of the penis; and erectile dysfunction. The chapter also considers adenocarcinoma of the kidney; transitional cell tumours; adenocarcinoma of the prostate; carcinoma of the penis; testicular tumours; haematuria; acute urinary retention (AUR); and acute testicular pain.

No Place for Old Men? Meeting the Needs of an Ageing Male Prison Population in England and Wales

Recent years have witnessed significant increase in numbers of older men imprisoned in England and Wales; a phenomenon experienced across the western world. Those aged fifty and over represent the fastest-growing demographic group in prison in England and Wales. This article summaries explanations for and implications of this increase and the characteristics, needs and lived experiences of this population, before critically reflecting on current policy and practice responses; and how responses highlight definitional and policy ambiguities around older prisoners. The article discusses a multi-agency initiative developed at one prison in northern England that recognised the uniqueness of older prisoners, modified regimes and changed physical environments. Impact is benchmarked against Her Majesty’s Inspectorate of Prisons four tests of a healthy prison, followed by discussion of findings and implications for policy and practice. The article argues for expanded collaboration to better manage challenges posed by older prisoners, supported by a national strategy.

Case Characteristics, Clinical Data, And Outcomes of Hospitalized COVID-19 Patients In Qom Province, Iran: A Prospective Cohort Study

The outbreak of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) dates back to December 2019 in China. Iran has been one of the most virus inflicted countries. The aim of this study was to report demographics, signs and symptoms, laboratory findings, therapeutic approaches, and outcomes. This observational cohort study was performed from 20th February 2020 to 20th July 2020. Patients’ information was recorded in their medical files. Multivariable analysis was performed to assess demographics, signs and symptoms, paraclinical data, treatments, outcomes of disease, and finding the risk factors of death subject to COVID-19. Of all 2468 participants, the mean age was 57.9±17.6 years and 56.8% of patients were male. The most significant comorbidities were seen among those who have Hypertension and Diabetes Mellitus. 14.42% were admitted to ICU, and 17.2% died in hospital. The significant risk factors of death were ageing, male gender, HTN, CHF, CVA, CKD, increasing ESR, PT, WBC, liver function tests, and decreasing Oxygen saturation. Incontinent results in the case of COVID-19 outcomes and death-related risk factors attribute to marked differences in demographics and health care systems. The patients with hazardous risk factors must be detected urgently and monitored closely to save more lives.

Effect of Eurycoma longifolia standardised aqueous root extract– Physta® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre study

Background: Low testosterone levels cause physiological changes that compromise the quality of life in ageing men. A standardised water extract from the root of Eurycoma longifolia (EL), known as Physta®, is known to increase testosterone levels. Objective: To evaluate the safety and efficacy of Physta® in improving the testosterone levels and quality of life in ageing male subjects. Design: This randomised, double-blind, placebo-controlled study enrolled 105 male subjects aged 50–70 years with a testosterone level <300 ng/dL, BMI ≥ 18 and ≤30.0 kg/m2. The subjects were given either Physta® 100 mg, 200 mg or placebo daily for 12 weeks. The primary endpoints were changes in serum total and free testosterone levels. The secondary endpoints included changes in the level of sex hormone-binding globulin (SHBG), dihydroepiandrosterone (DHEA), glycated haemoglobin (HbA1c), insulin-like growth factor-1 (IGF-1), thyroid function tests (T3, T4, TSH and Free T3) and cortisol. Changes in Ageing Male Symptoms (AMS) score, Fatigue Severity Scale (FSS) score and muscle strength are other secondary endpoints. The safety of the intervention products was measured by complete blood count, lipid profile, liver and renal function tests. Results: There was a significant increase in the total testosterone levels at week 12 (P < 0.05) in the Physta® 100 mg group and at weeks 4 (P < 0.05), 8 (P < 0.01) and 12 (P < 0.001) in the Physta® 200 mg group compared to placebo. No significant between-group differences in free testosterone levels were observed but a significant within-group increase occurred at weeks 4 (P < 0.01), 8 (P < 0.001) and 12 (P < 0.001) in the Physta®100 mg group and at weeks 2 (P < 0.01), 4 (P < 0.01), 8 (P < 0.001) and 12 (P < 0.001) in the Physta® 200 mg group. The AMS and FSS showed significant reduction (P < 0.001) in total scores at all time-points within- and between-group in both Physta® groups. DHEA levels significantly increased (P < 0.05) within-group in both Physta® groups from week 2 onwards. Cortisol levels significantly (P < 0.01) decreased in the Physta® 200 mg group, while muscle strength significantly (P < 0.001) increased in both Physta® groups at week 12 in the within-group comparison. There were no significant changes in SHBG. No safety related clinically relevant changes were observed. Conclusion: Supplementation of Physta® at 200 mg was able to increase the serum total testosterone, reduce fatigue and improve the quality of life in ageing men within 2 weeks’ time. Trial registration: This clinical study has been registered in ctri.nic.in (CTRI/2019/03/017959).

Acute urinary retention in a 27-year-old male secondary to benign prostatic hyperplasia treated with Holmium Enucleation of the Prostate (HOLEP)

Introduction: Benign prostatic hyperplasia (BPH) is common in the ageing male. Clinical manifestations like retention impact on a patient’s quality of life. Alterations in androgen activity at the androgen receptor complex level in the prostate contribute to prostatic hyperplasia with the highest incidence occurring in males in their 70’s. There remains a paucity of cases in young males who develop acute urinary retention secondary to BPH. We present a case of a 27-year-old male who developed acute urinary retention secondary to BPH who required a Holmium Laser Enucleation of his Prostate (HOLEP). Case description: A 27 year old man was admitted in acute urinary retention. BPH was diagnosed via way of radiological imaging and histological assessment. After pre-operative sperm banking and suprapubic catheterisation, the patient underwent a HOLEP. He had biochemically confirmed hypogonadotrophic hypogonadism which was at odds with his muscular, physical appearance. Total testosterone levels had fluctuated following admission suggesting an exogenous substance was interfering with the hypothalamic-pituitary-gonadal axis but he denied exogenous steroid use. Result: The patient successfully passed his voiding trial on the second post-operative day and remained catheter free. Post-operative uroflowmetry and sexual function remain unknown as patient disengaged with follow up. Conclusion: HOLEP prostatectomy is a safe and effective way of managing BPH in younger patients following sperm banking and assessment by endocrinology.

EFFECT OF AUDITORY DISTRACTION ON HAND AND FOOT REACTION TIME AMONG AGEING MALAYSIAN AUTOMOBILE DRIVERS

The involvement of ageing drivers in traffic accidents were reported but little cited on the severity of auditory driving distractions. Driving distraction contributes to increases in reaction time which can lead to safety traffic risks. Thus, in this study, hand and foot reaction times were measured in response to different distractions within the identical simulated driving route. The task varies in a controlled setting where soundless distractions were present, Comfortable Loudness Level (CLL), Uncomfortable Loudness Level (ULL) auditory distractions, and phone call distraction. Participants were among 40 Malaysian driving license holders consists of 57.5% males and 42.5% females with age mean, (M=51.83, SD=14.058). Results indicated that both hand and foot reaction time were shortest for CLL and longest during phone call. Ageing male scored shortest hand reaction time of 1.15s during CLL distraction. For foot reaction time, ageing male scores shortest of 0.92s for both CLL and no distractions. Pearson’s coefficient of correlation shows r>0.5. The results indicated hand reaction time was affected by foot reaction time (r=0.665), was significantly more for foot when compared with hand, could be because of difference in nerve conduction velocity and movement time of the hand when compared with that of foot.