Manual Workers Research Articles

Unpacking occupational and sex divides to understand the moderate progress in life expectancy in recent years (France, 2010's).

The growth in life expectancy (LE) slows down recently in several high-income countries. Among the underlying dynamics, uneven progress in LE across social groups has been pointed out. However, these dynamics has not been extensively studied, partly due to data limitations. In this paper, we explore this area for the 2010 decade using recent French data. We utilize the recent change in French census mortality follow-up data (EDP) and apply P-spline models to estimate LEs across five occupational classes (OCs) and indicators of lifespan heterogeneity (edagger) within these OCs, for seven triennial periods (2011-2013 to 2017-2019). First, we found a similar ranking of OCs along the LE gradient over time and across sexes, from manual workers to higher-level OCs. Noteworthy, the lowest LE in women overlaps with the highest one in men drawing a sex-OC gradient. Second, we observe varying progress of LEs. In women, LE increases in higher-level OCs meanwhile it levels off in manual workers, so that the OCs gap widens (up to 3.4 years in 2017-2019). Conversely, in men LE stalls in higher-level OCs and increases in manual workers so that the gap, which is much larger than in women (+5.7 years in 2017-2019), is tending to narrow. Finally, the lifespan homogenizes in OCs only when LE is low. Overall, the limited LE progress in France results from LE stalling in the middle of the sex-OC gradient, though LE increases at both ends. At the lower end, LE progress and lifespan homogenization suggest that laggards benefit recently improvements achieved earlier in other OCs. At the upper end, LE progress may come from a vanguard group within higher-lever OC, benefiting new sources of improvements. These findings underscore the need for further research to explore the diverse mortality dynamics coexisting in the current health landscape.

Organised Violence, Inequality and Work: Violence Specialists as a Classed Occupation

Scholars have long debated what is the role of inequalities in organised violence, but the causal mechanisms remain unclear. I argue that mainstream approaches (e.g. deviance, subcultures, grievances, rational choice and Marxism) fall short because they overlook that organised violence is an intensive form of work. These perspectives often exoticise individuals involved in violence for profit or political purposes. Violence is not a deviant feature of social life but an integral part of collective action. By applying occupational lenses, I position those engaged in violence as a specialised class of manual workers recruited in the protection labour market. Scholars can acknowledge the occupational stratification observed before in research about organised violence by understanding violence specialists as workers. This essay explores how the sociology of work can enhance our understanding of inequality reproduction within criminal organisations, guerrillas, armies, police forces, mercenaries and private military companies.

Arduino-Based Electromyography System for Enhanced Monitoring and Optimisation of Oil Palm Harvesting Manual Workers

Arduino-Based Electromyography System for Enhanced Monitoring and Optimisation of Oil Palm Harvesting Manual Workers

Coverage of mammography imaging in and outside an organized breast cancer screening program - variation by age and sociodemographic groups.

In recent decades, attendance to organized breast cancer screening has been decreasing in European countries. This could be partly due to an increase in the use of opportunistic screening. The aim of this study was to assess the coverage of imaging in and outside the screening program in Finland during the period of 1999-2018. We also compared the usage of imaging services across sociodemographic groups in the more recent years (2017-2018). Our initial data consisted of 1,159,000 screening-target-aged women (50-69 years) in 1999-2018 and 1,849,000 women aged 30-89 years in 2017-2018. Data on organized breast cancer screening program was drawn from the Finnish Cancer Registry and supplemented with comprehensive individual data on mammograms and ultrasounds performed outside the program. Among the screening-aged women (50-69), a clear decline in the overall imaging coverage was observed during the study period (from 89 to 85%). The use of outside imaging increased slightly but not enough to compensate for the overall decrease. There were large differences in coverages between sociodemographic groups. Compared to manual workers and the unemployed, upper-level employees were around two times more active in using outside imaging (8.2% vs. 3.6% and 4.3%, respectively). Overall breast imaging coverage has slowly decreased during the 2000s, while outside imaging has increased slightly. The coverage of imaging in and outside the program largely followed the same trends, with the highest usage concentrating on higher socioeconomical groups, native speakers and highly educated women.

Pattern of Musculoskeletal Manifestation in Patient with Diabetes Mellitus

Background: Diabetic mellitus (DM) both type 1 and type 2 increasing dramatically throughout worldwide. DM involved all the vital organs including musculoskeletal system. Objective: The purpose of study was to find out patterns of musculoskeletal manifestation (MSM) in diabetic patients & to find out a strategy to improve the outcome of the MS complications in patients with Diabetes Mellitus. Material and Methods: This was hospital based observational study conducted on 143 diabetics patients with musculoskeletal manifestations, both men and women (aged e”15- 70 years) visited in outpatient department and hospital admitted patient in a tertiary care of teaching hospital. Patterns were defined by a meticulous history, relevant general and systemic examination & with the aid of musculoskeletal (MS) Function Assessment semi structured Questionnaire. Results: MSM are common among patients with type 2 diabetes Out of 143 patients in our study 103(72.03%) were Male and 40(27.97%) were female, and male –female ratio 2.57:1. The age distribution of study patients was 15 to 70 years. Overall, 72.03.% of patients were among the 40-59 years old and about 20.28% were 60 years and mean age of the patients was 55±5. Above which is statistically significant (P= 0.048). The shoulder involvement as adhesive capsulitis (frozen shoulder) was found among 69(48.25%) on the diabetic cohort and statistically significant (P= <.05) and mostly among the housewife (27.99%) and manual worker like cultivator (13.99%). Degenerative osteoarthritis was commonly associated with MSM with DM than inflammatory arthritis. Conclusion: In our study shows degenerative, non-inflammatory MSM are common among the diabetic patients that leads to significant pain and disability that directly related with poor glycemic control and co-morbidities like stroke and obesity. Early recognition of these complications, and multidisciplinary management between diabetes and rheumatology specialists is necessary to reduce morbidity. EWMCJ Vol. 12, No. 1&2, January-July 2024: 66-69

Sickness absence due to mental and somatic diagnoses by occupational class in Finland, 2011–2021

Abstract Background Sickness absence (SA) due to mental disorders has strongly increased in Finland during recent years while sickness absence due to somatic diagnoses has continued to decrease. Research is lacking on recent trends in SA by occupational class, especially during years of increasing mental disorders. The aim of the study is to analyze these trends during 2011-2021. Methods National register data from the Social Insurance Institution of Finland (Kela), Statistics Finland and Finnish Centre for Pensions were linked for all employed Finns aged 25-64 for years 2011-2021 (yearly N about 2 million). SA was measured by sickness allowance, compensated by Kela after 10 days of absence. Age-standardized yearly prevalences of SA due to different diagnoses were calculated for women and men in four occupational classes over 2011-2021. Logistic regression was used to assess differences between occupational classes adjusted for age, marital status, education and region of residence. Results SA due to mental disorders has greatly increased in all occupational classes in Finland after year 2016 among both women and men, while SA due to musculoskeletal and other somatic diagnoses has continued to decrease. Increase in SA due to mental disorders has been largest among lower non-manual employees, especially among women, whereby also overall SA prevalence among female lower non-manual employees has reached the level of manual workers. Men show broadly similar trends but manual workers still have the highest overall SA prevalence. Relative adjusted differences between occupational classes decreased slightly between 2011 and 2021. Conclusions Clear occupational class differences persisted in diagnosis-specific SA throughout 2011-2021. However, the magnitude and order of the class differences changed along with increasing SA due to mental disorders. Occupational class differences should be taken into account when aiming to prevent further increases in SA due to mental disorders. Key messages • Sickness absence (SA) due to mental disorders has increased in all occupational classes in Finland after year 2016, while SA due to somatic diagnoses has continued to decrease. • Increase in SA due to mental disorders has changed the overall occupational class differences in SA in Finland largely because the increase has been strongest among lower non-manual employees.

Association of Tobacco With Neck Node Metastasis In Supra-Glottic Carcinoma of Larynx

Background: Carcinoma larynx is one of the most common cancers in the head neck region. Mortality and morbidity in this disease is still high in spite of modern treatment modalities. Smoking and Alcohol is recognized as common predisposing factor for carcinoma larynx. Neck node metastasis increases the mortality twice than the primary alone. Most of the Laryngeal carcinoma patient with neck node metastasis are smoker in our country. Stopping the consumption of tobacco may reduce both mortality and morbidity of carcinoma larynx. Metastasis is more common in supra-glottic carcinoma of larynx. This study is carried to observe the association of tobacco with lymph node metastasis in supra-glottic carcinoma of larynx. Materials and Methods: This cross sectional study was conducted in Otolaryngology and head Neck surgery department of Dhaka Medical College and Mitford Hospital of Dhaka, Bangladesh from June 2013 to June2015 .212 cases of supra-glottic carcinoma age ranging from 35 year to 90 years (mean age 63.6 ±11.65) was included in this study. Results: Sixty two percent patients were diagnosed with cervical lymph node metastasis. 83.28% patients with nodal metastasis were above 60 years of age and 75.67% patients were manual worker.100% node positive patients were smoker. Smoking for longer period (>30yrs) and higher in number (>30 sticks/day) were found in advanced stage. Significant association was found between site, size, macroscopic features, cellular differentiation and demographic factors of patient with neck node metastasis in supra-glottic carcinoma larynx. Conclusion: As neck node metastasis significantly reduces prognosis so we must be more attentive towards factors that increase the chance of nodal metastasis to avoid the advancement of the disease. J Dhaka Med Coll. 2023; 32(1) : 51-56

Analysis of Risk Factors on Patellofemoral Osteoarthritis: Distribution Characteristics and Radiographic Parameters of Patellofemoral Joint.

The risk factors for the degeneration of the patellofemoral joint (PFJ) have not been adequately and thoroughly studied. This study aimed to analyze the population distribution characteristics of patients with patellofemoral osteoarthritis (PFOA) and assess the correlation between PFOA and radiological parameters, including patella morphology, PFJ congruity, and patellar alignment. Moreover, the risk factors across various demographic groups were further analyzed. A retrospective analysis was conducted to examine the population distribution characteristics of PFOA patients from September 2020 to September 2023. Radiological parameters of the PFJ were measured from the anteroposterior and lateral views of knee joint as well as axial view of patella using X-ray imaging and the PACS imaging system at the First Affiliated Hospital of Kunming Medical University. These parameters included patella morphology (patella type, width, thickness, and Wiberg index), PFJ congruity (patella height, Wiberg angle, sulcus angle, and lateral patella angle), and patellofemoral alignment (patella tilt angle, displacement, and lateral patellofemoral angle). PFOA severity was classified according to the Iwano PFJ radiological classification, and its correlation with the aforementioned parameters was examined. Additionally, risk factors for PFOA across different populations were further evaluated. The study included 1080 patients according to the inclusion and exclusion criteria. Age, female gender, overweight or obesity, and manual workers were significantly associated with PFOA. Moreover, type III patella (OR = 3.03, p < 0.05), greater patella width (OR = 1.12, p = 0.01), sulcus angle (OR = 1.04, p < 0.01), patella tilt angle (OR = 1.13, p < 0.01), and patella displacement (OR = 1.22, p < 0.01) as well as smaller patella thickness (OR = 0.87, p < 0.01), Insall-Salvati index (OR = 0.24, p = 0.04), and lateral patellofemoral angle (OR = 0.93, p = 0.02) were identified as risk factors for PFOA. Furthermore, greater patella thickness (OR = 1.17, p < 0.05) and smaller patella displacement (OR = 0.79, p < 0.01) correlated with higher Kujala patellofemoral scores. Discrepancies in risk factors across different populations were also observed. Older age, female gender, obesity, manual workers, and specific aberrations in patellofemoral parameters are predictive factors for PFOA. Additionally, greater patella thickness and smaller patella displacement were associated with increased severity of clinical symptoms. Thus, more attention should be paid to the discrepancies that exist in different populations.

The feeling of falling behind: societal fear and anti-immigration attitudes among manual workers

The feeling of falling behind: societal fear and anti-immigration attitudes among manual workers

Exploring the Link Between Parental Sociodemographic Characteristics and Multiple Births: Insights from National Birth Data in Japan, 1995-2020.

This present study investigated the parental characteristics of multiple births using national birth data in Japan. This study included birth data from Vital Statistics: Occupational and Industrial Aspects every five fiscal years from 1995 to 2020. The multiple birth rates were defined as the number of live-birth deliveries with multiple fetuses (e.g., twins, triplets) per total live-birth deliveries. Parental ages, nationalities, occupations and household occupation (occupation of the top earner of the household) were considered as parental characteristics. The multiple birth rates were calculated based on parental characteristics for each year, and a log-binomial regression model was used to assess the association between parental characteristics and multiple births. The multiple birth rate for Japanese mothers consistently exceeded that for non-Japanese mothers over the years, and the rate increased progressively from manual workers to lower non-manual workers and then to upper non-manual workers for both maternal and paternal occupations. The regression results indicated that the risk ratio (RR) for multiple births among non-Japanese mothers was significantly lower than that among Japanese mothers. Moreover, concerning household occupation, the RRs of self-employed individuals, full-time employees at smaller companies, others, and the unemployed were significantly lower than those of full-time employees at larger companies. Furthermore, the RRs of lower non-manual and manual workers were significantly lower than those of upper non-manual workers in maternal and paternal occupations. The results suggested an association between multiple births and parental socioeconomic status in Japan.

Functional evaluation after cortical button fixation for distal biceps ruptures – Is there any difference between manual or non-manual workers?

BackgroundThis study aims to compare clinical and functional results after distal biceps tendon repair in manual workers vs. non-manual workers. MethodsThis is a retrospective comparative study which refers to 57 cases with distal biceps tendon rupture, divided in manual workers (24 elbows) and non-manual workers (33), that were treated by a single incision with cortical button and interference screw fixation. Included cases have a minimum of 3 months follow-up, post-operative X-ray and signed informed consent for the investigation. ResultsSupination and flexion strength was higher in manual workers vs. non-manual workers (p-value=0.192 and 0.878, respectively). Nine patients showed loss of range of motion, concerning supination and pronation, and this was correlated to worse functional scores. Functional scores tend to be superior in non-manual workers. Ten patients had heterotopic ossification and 20 patients reported lateral antebrachial cutaneous nerve neuropraxia; one had both. Most of them had a full recovery. ConclusionAccording to clinical evaluation and post-operative scores, the performed surgical procedure provides good to excellent mid-term functional results. Nevertheless, there were not any differences between manual or non-manual workers.

Hand and wrist complete degloving: A case report and litterature review

Complete hand degloving injuries are traumatic avulsion injuries causing the skin to pull away from the underlying tissues and are most often caused by industrial machinery. We present the case of a degloving trauma of the whole fingers, hand, and wrist resulting in a "watch hand" by analogy with the "ring finger" and discuss alternatives and recommendations from the rare cases described of similar traumas. A 33-year-old manual worker, a non-smoker with no significant medical or surgical comorbidities, was admitted for a complete skin avulsion of the left hand and wrist following a work-related accident with a trommel-type industrial roller. Our approach covered the five fingers and the dorsal aspect of the hand and wrist with an artificial dermal matrix, while the palmar side of the hand and wrist was covered with a pedicled groin flap in emergency. At 15months, the patient's sensitivity was classified as S1 on the sensory evaluation scale, joint mobility was less than 30°, and the residual hand retained what we might call "basic" functions, i.e., a counterweight when carrying loads and the ability to pick up and hold a light object in the thumb-index grasp. Complete soft tissue hand defects are exceptional and require urgent treatment. If re-implantation is not possible, combining a dermal matrix with a pedicled flap is a simple salvage solution. The risks of vascular, infectious, and stiffening complications in these traumas are high and must be prevented. Patients must be warned of the severity of the trauma, the need for secondary surgeries to restore a policy-digital grip, and the poor functional results expected.

Empirical research on decent work and precarious work for semi-skilled and unskilled blue-collar workers: A scoping review

Recognising that many workers worldwide often face poverty and exploitation, the International Labour Organisation aims to promote decent and productive work opportunities for all. We conducted a scoping review to get an overall view of current academic literature on decent work and precarious work for samples of blue-collar workers. The studies included in this review, focused on empirical research conducted from 2006 onwards, that primarily investigated decent work or precarious work among semi-skilled and unskilled manual workers. The review team used a data-charting form and collected information from thirty-five articles. Most recent studies (2020–2023) were related to the experiences and livelihoods of non-traditional blue-collar workers namely platform drivers and informal waste pickers. Before 2020, the most commonly studied theme related to the experiences of migrant workers. The findings shed light on the experiences of these workers, particularly in South Africa and India and provide valuable insight into their work experiences for further discussion.

Evaluation and Surveillance of Lateral Elbow Tendinopathy in Manual Workers: Identifying Elbows at Risk

Abstract Background: Manual workers are at risk of developing lateral elbow tendinopathy (LET). We aimed to validate the hypothesis that asymptomatic elbows of manual workers with LET are more likely to have positive physical examination results and morpho-mechanical changes on elbow ultrasonography compared to healthy individuals. Methods: This cross-sectional case–control study included 30 manual workers with unilateral LET (LET group) and 30 age- and sex-matched healthy volunteers (control group). Demographic data collection and functional evaluation were performed using the Disabilities of the Arm, Shoulder, and Hand; Patient-Rated Tennis Elbow Evaluation; and European Quality of Life Five-Dimensions questionnaires. Physical examination of the elbows and evaluation of the common extensor tendon (CET) with B-mode morphology ultrasonography and Young’s modulus elastography were performed. The LET-unaffected and LET-affected elbows in the LET group were compared with the elbows in the control group. Results: The LET-unaffected elbows in the LET group had a higher prevalence of positive chair test results and focal hypoechoic change and microcalcification on ultrasonography than those in the control group (P &lt; 0.05, 0.005, and 0.05, respectively). In addition, LET-affected elbows showed higher focal hypoechoic change, microcalcification, erosive cortex, and neovascularity than elbows in the control group (P &lt; 0.001, 0.001, 0.005, and 0.001, respectively). The unaffected and affected elbows showed greater CET thickness than those in the control group (P &lt; 0.05 and 0.005). Conclusion: The unaffected elbows of manual workers with unilateral LET should be considered at risk of LET. We proposed a risk assessment and surveillance protocol based on chair test results and abnormal ultrasonographic findings.

Challenges to Empowerment of Women through Value Chains: The Need to Move from Individual to Relational Empowerment

ABSTRACTThis article examines the prevailing assumption by donors that connecting smallholder women to value chains will close the gender gap and empower women. Based on a case study of a programme that seeks to empower women through their integration into value chains in Vietnam, the article assesses women's empowerment across four dimensions: economic, psychological, social and political. The authors argue that women's engagement in value chains does not always financially benefit and empower women because patriarchal power structures within families, communities and businesses make it challenging for women to gain authority over production decisions in higher‐value crops. Women in the study gained more autonomy over ‘women's crops’ which yielded small incomes, while men had control over production that was seen as ‘men's work’, and in large‐scale and more lucrative production. Gendered power relations affect women's access to economic opportunities: in this context, development agencies should reconsider their approaches to women's economic empowerment by focusing on relational rather than individual empowerment. This means that women's economic empowerment programmes should involve both men and women, with targeted interventions ensuring women are empowered within the household and in their connections with the community, local authorities and businesses.

Dietary Differences by Job Type and Industry Among Workers in Japan During the COVID-19 Pandemic: A Cross-Sectional Study.

The coronavirus disease 2019 (COVID-19) pandemic forced people to change their lifestyles. We examined dietary differences by job type and industry among workers during the pandemic. This cross-sectional study was conducted using data an internet survey. Job type and industry were classified into 3 and 22 groups, respectively. Dietary behaviors were assessed using self-reported questionnaires. Logistic regression analysis nested in the workplace prefecture was conducted. Workers involved in jobs that required communication with people were more likely to skip breakfast (odds ratio [OR]: 1.17, 95% confidence interval [CI]: 1.10-1.24) and had a lower meal frequency (OR: 1.25, 95% CI: 1.17-1.34) than workers engaged in desk work. Manual workers were more likely to eat fast food or meals (OR: 1.10, 95% CI: 1.03-1.17) than were those engaged in desk work. Workers in the newspaper, magazine, television, radio, advertising, and other mass media industries were more likely to skip breakfast (OR: 2.43, 95% CI: 1.82-3.24) and have a lower meal frequency (OR: 3.90, 95% CI: 2.87-5.28) than workers in public offices and organizations. These results were partially consistent with trends reported before the pandemic. Further studies should be conducted to clarify the causes of differences in dietary behavior among workers.

The Environmental Perception and Vegetarian Motivation of People in Ho Chi Minh City, Vietnam

Abstract Studies have previously shown that there were many vegetarian movements in the world, using many different models to indicate vegetarian food choice behavior. Among the factors affecting the motivation to become a vegetarian, perception and attitude are considered important factors influencing the decision to switch from using foods of animal origin to plant-based ones. There are many measured aspects of perception ranging from health, religion, love of animals, or animal rights. Among these, environmental perception increasingly shows a clear influence on vegetarian motivation, especially for young people. This current study aims to find out whether factors relating to perception including environmental perception, influence people’s motivation to become vegetarian in Ho Chi Minh City. To achieve this goal, the research surveyed 360 people living in Ho Chi Minh City (divided into three groups (students, office workers, and manual workers) using a direct questionnaire. Research results show that among the four independent variables (perception, ability, opportunity, barriers), there are three variables (1) perception; (2) opportunity; and (3) barriers having a significant relationship with the vegetarian motivation of people in Ho Chi Minh City. From the findings, this study points out key highlights in people’s current vegetarian food choices in this area, including environmental perception.

Stratégie de suivi des patients dans un centre SOS main universitaire labellisé FESUM-Intégration des étudiants de 3e cycle : une étude prospective

Introduction: FESUM (Federation of Hand Emergency Services) is a European network of hand emergency centers (called SOS hand centers) in France, Belgium and Luxembourg. The FESUM network includes 64 SOS Hand centers in France. In our university hospital, the FESUM-certified SOS hand has been part of the plastic surgery department since 2001. It has included, since 2016, postgraduate students (“residents‿) training in hand surgery who participate independently in the patient follow-up. The objective of this study was to analyze the characteristics of this population of patients with hand injuries and their satisfaction with this mode of follow-up. The secondary objective was to study the characteristics of the patient population treated by our center.Material and method: We conducted a study on the follow-up of patients undergoing emergency hand surgery, prospective, single-center, declarative, anonymized, between May and October 2021 at the SOS main center of our university hospital at the “SOS Main‿ intern consultation. The demographic data, the main characteristics of the pathology, the elements of initial care and follow-up of the patients as well as their satisfaction were analyzed, as well as the satisfaction of the interns.Results: We included 323 patients. The population of patients treated generally corresponded to a young man, manual worker, who was initially treated in an outpatient department or in an SOS Hand consultation. The lesions most often represented were fractures (24%), tendon wounds (18%) and wounds without damage to noble tissues (16%). Follow-up consultations took place mainly 15 days after the emergency intervention, lasted on average 10 minutes and did not present excessive delays. Patient (91,2 %) and post-graduate student (87,2 %) satisfaction was high. However, post-operative physiotherapy follow-up was insufficient, as was self-rehabilitation.Conclusion: The integration of post-graduate student in a university plastic surgery department into the care of SOS Hand patients seems beneficial for all those involved, and for their training. The characteristics of the follow-up consultations by the intern in autonomous supervision corresponded to the high quality standards of the FESUM. The patients showed a high satisfaction rate. Better valorization of this consultation in “Office Surgery‿ should be considered.

Lower total cholesterol and triglyceride levels in ankylosing spondylitis than non-inflammatory rheumatic disease controls in a 1978-98 study: a potential effect of increased physical energetics in manual occupations in the pre-2000 chronologic era.

No article on serum lipids in ankylosing spondylitis (AS) and control subjects has been reported from USA. The primary aim of this study was to determine if any difference occurred in serum lipid levels in AS and control rheumatic disorders in two time periods, 1978-98 and 2000-10. The secondary aim was to investigate variables associated with lipid levels and if a difference was found between AS and control disorders. The AS patients were compared to non-inflammatory rheumatic disorders (NIRDs) in 1978-98 and 2000-10 surveys and to rheumatoid arthritis (RA) in the 2000-10 survey. Patients were matched within 5 years of age, sex, and clinic or hospital source. In the 1978-98 survey, entry mean (SEM) serum cholesterol level [mg/dL] was highly (p<0.001) significantly lower in 69 AS [179.0 (4.8)] than 69 matched NIRD controls [208.0 (5.6)]. In 29 pairs of AS and NIRD subjects having manual labour occupations, mean (SEM) cholesterol level was additionally lower in AS [156.7 (5.9)] and higher in 29 NIRD controls [213.3 (8.6)] (p<0.001). In manual labour workers, mean (SEM) serum triglyceride was significantly lower (p=0.004) in 15 AS [110.3 (14.1)] than 14 NIRD controls [185.2 (19.3)]. In the 2000-10 survey, no lipid difference was found between AS vs. NIRD control patients. In the 1978-98 survey, AS had significantly lower mean serum cholesterol and triglyceride levels than NIRD control patients. Associated manual labour occupations may have significantly contributed to results, possibly related to increased energy expenditures from physical activity in the pre-2000 era.

Finding the Missing Men with Tuberculosis: A Participatory Approach to Identify Priority Interventions in Uganda.

Gender impacts exposure and vulnerability to TB, evidenced by a higher prevalence of both TB disease and missed TB diagnoses among men, who significantly contribute to new TB infections. We present the formative research phase of a study which used participatory methods to identify gender-specific interventions for systematic screening of TB among men in Uganda. Health facility level data was collected at four Ugandan general hospitals (Kawolo, Gombe, Mityana, and Nakaseke) among 70 TB stakeholders, including healthcare workers, TB survivors, policymakers, and researchers. Using health seeking pathways, they delineated and compared men's ideal and actual step-by-step TB health seeking processes to identify barriers to TB care. The stepping stones method, depicting barriers as a 'river' and each 'steppingstone' as a solution, was employed to identify interventions which would help link men with TB symptoms to care. These insights were then synthesized in a co-analysis meeting with 17 participants including representatives from each health facility to develop a consensus on proposed interventions. Data across locations revealed the actual TB care pathway diverted from the ideal pathway due to health system, community, health worker and individual level barriers such as delayed health seeking, unfavourable facility operating hours and long waiting times that conflicted with men's work schedules. Stakeholders proposed to address these barriers through the introduction of male-specific services; integrated TB services that prioritize X-ray screening for men with cough; healthcare worker training modules on integrated male-friendly services; training and supporting TB champions to deliver health education to people seeking care; and engagement of private practitioners to screen for TB. In conclusion, our participatory co-design approach facilitated dialogue, learning, and consensus between different health actors on context-specific, person-centred TB interventions for men in Uganda. The acceptability, effectiveness and cost effectiveness of the package will now be evaluated in a pilot study.