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The normal and the pathological

Musculoskeletal disorders are among the most common causes of sickness absence, long-term incapacity for work and ill-health retirement. The number of Incapacity Benefit (IB) recipients in the United Kingdom has trebled since 1979, despite improvement in objective measures of health. Most of the trend is in non-specific conditions (largely subjective complaints, often with little objective pathology or impairment). Understanding incapacity requires a biopsychosocial model that addresses all the physical, psychological and social factors involved in human illness and disability. Rehabilitation should be directed to overcome biopsychosocial obstacles to recovery and return to work. These principles are fundamental to better clinical and occupational management and minimizing incapacity. Sickness absence and incapacity from non-specific musculoskeletal conditions could be reduced by 33-50%, but that depends on getting all stakeholders onside and a fundamental shift in thinking about these conditions-in health care, in the workplace and in society.

/pdf/preventing-incapacity-in-people-with-musculoskeletal-5ftfu0ggka.pdf

Preventing incapacity in people with musculoskeletal disorders

Dunya Saglik Orgutu Cin Ulke Ofisi, 31 Aralik 2019 tarihinde, Cin’in Hubei eyaletinin Vuhan sehrinde, sebebi o an icin bilinmeyen zaturre vakalari bildirmis ve 5 Ocak 2020 tarihinde ise, daha once insanlarda tespit edilmemis yeni bir coronavirus tanimlanmistir. Baslangicta 2019-nCoV olarak ifade edilen bu hastalik, daha sonra Covid-19 olarak adlandirilmis ve Cin’de ortaya ciktiktan sonra, uc ay gibi kisa bir sure icerisinde tum dunyayi etkisi altina almistir. 12 Mart 2020 itibariyle Dunya Saglik Orgutu tarafindan pandemi olarak ilan edilen Covid-19 salgini; fiziksel, ruhsal ve sosyal olarak dunya insanligini tehdit etmeye devam etmektedir. Dunya Saglik Orgutu verilerine gore; 12 Mayis 2020 itibariyle, dunya genelindeki Covid-19 kaynakli vaka sayisinin 4 milyon 88 bin 848’e ulastigi, olum sayisinin ise 283 bin 153 oldugu gorulmektedir. Turkiye’de ise ilk olarak 11 Mart 2020 tarihinde gorulen Covid-19 vakasindan 12 Mayis 2020 tarihine kadar gecen sure zarfinda; toplam vaka sayisi 141 bin 475 iken, Covid-19 kaynakli toplam olum sayisi ise 3 bin 894 olarak belirtilmektedir. Bu calismanin amaci; guncel veriler ve literatur isiginda, Covid-19 pandemisini genel olarak degerlendirmek ve pandemi surecinin, dunyadaki diger ulkelerle birlikte Turkiye’deki etkisini de dikkate alarak, cikarimlarda bulunmaktir.

/pdf/covid-19-pandemi-surecine-yonelik-genel-bir-degerlendirme-79nfcp4vkc.pdf

Covid-19 pandemi̇ süreci̇ne yöneli̇k genel bi̇r değerlendi̇rme: türki̇ye örneği̇

This article examines the conceptual history and contemporary usages of the term "healing." In response to longstanding definitional ambiguity, reflections are offered on what are termed the diagnostic criteria, nosology, and etiology of healing. First, a summary is provided of how healing has been defined within medicine. Second, the dimensionality of healing is discussed. Third, healing's putative determinants are outlined. For biomedicine, healing mainly concerns repair of wounds or lesions and is unidimensional. For complementary medicine, by contrast, healing has been defined alternatively as an intervention, an outcome, and a process-or all of these at once-and is multidimensional, impacting multiple systems from the cellular to the psychosocial and beyond. Notwithstanding these usages, a review of medical texts reveals that healing is rarely defined, nor is its dimensionality or determinants described. Persistent lack of critical attention to the meaning of "healing" has implications for medical research and practice.

What is “Healing”?: Reflections on Diagnostic Criteria, Nosology, and Etiology

Self-rated health is widely considered a good indicator of morbidity and mortality but its validity for health equity analysis and public health policies in Italy is often disregarded by policy-makers. This study had three objectives. O1: To explore response distribution across dimensions of age, chronic health conditions, functional limitations and SRH in Italy. O2: To explore associations between SRH and healthcare demand in Italy. O3: To explore the association between SRH and household income. Cross-sectional data were obtained from the 2015 Health Interview Survey (HIS) conducted in Italy. Italian respondents (n = 20,814) were included in logistic regression analyses. O1: associations of chronic health conditions (CHC), functional limitations (FL), and age with self-rated health (SRH) were tested. O2: associations of CHC, FL, and SRH with hospitalisation (H), medical specialist consultations (MSC), and medicine use (MU) were tested. O3: associations of SRH and CHC with household income (PEI) were tested. O1: CHC, FL, and age had an independent summative effect on respondents’ SRH. O2: SRH predicted H and MSC more than CHC; age and MU were more strongly correlated than SRH and MU. O3: SRH and PEI were significantly correlated, while we found no correlation between CHC and PEI. Drawing from our results and the relevant literature, we suggest that policy-makers in Italy could use SRH measures to: 1) predict healthcare demand for effective allocation of resources; 2) assess subjective effectiveness of treatments; and 3) understand geosocial pockets of health inequity that require special attention.

/pdf/self-rated-health-as-a-valid-indicator-for-health-equity-589hxaestz.pdf

Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey

Concepts such as disease and health can be difficult to define precisely. Part of the reason for this is that they embody value judgments and are rooted in metaphor. The precise meaning of terms like health, healing and wholeness is likely to remain elusive, because the disconcerting openness of the outlook gained from experience alone resists the reduction of first-person judgments (including those of religion) to third-person explanations (including those of science).

https://mh.bmj.com/content/medhum/26/1/9.full.pdf

Kenneth M Boyd

Papers

Disease, illness, sickness, health, healing and wholeness: exploring some elusive concepts.