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OCCUPATIONAL APPLICATIONSErgonomic risk assessment is a key step in managing work-related musculoskeletal disorders. Diverse assessment methods exist, and errors may occur if inappropriate methods are selected. Understanding the level of knowledge, how to use methods, and exploring factors affecting erroneous usage of these methods, can provide useful information for health and safety regulatory authorities and decision-makers to identify problems and determine an action plan to eliminate them. We found that Iranian occupational health specialists have little knowledge about the types of pen-and-paper observational methods (OMs), and most of them use a limited number of these methods. Content analysis of interviews identified three main categories of influential factors and 12 subcategories. The main categories were educational, individual, and organizational factors. These results suggest the need for more effort to ensure that practitioners possess better knowledge and skills in the selection and application of pen-and-paper OMs.Background Ergonomic risk assessment is a key step in managing ergonomics in the workplace. Errors in selecting risk assessment methods may occur during risk assessment and could invalidate the reliability of the results obtained.Purpose The aims of the present study were to investigate Iranian occupational health specialists’ knowledge and application of pen-and-paper observational methods (OMs) for ergonomics assessment and to determine their influential factors.Methods We used a mixed-method design in two phases, combining quantitative and qualitative approaches. Quantitative data were collected from 237 occupational health specialists who were included in the study through purposive sampling of experts. In the qualitative phase, in-depth semi-structured interviews were conducted with participants from the first phase, and the factors associated with the selection and application of the pen-and-paper OMs were examined over a 6-month period.Results Participants were familiar with 13 out of 34 methods studied, and they had performed risk assessments with only nine of them. The most frequently used methods were RULA (95.4%), REBA (84.8%), QEC (65.4%), and ROSA (54.9%). Content analysis of interviews identified three main categories of influential factors and 12 subcategories. The main categories included educational, individual, and organizational factors.Conclusion Iranian occupational health specialists were found to have relatively limited knowledge about pen-and-paper OMs, and most of them use a limited number of these methods. These results suggest the need for more effort to ensure that practitioners possess better knowledge and skills in the selection and application of these methods. Creating stricter regulations regarding the qualifications of practitioners, modifying academic curriculum content, continuously monitoring the performance of practitioners, and holding retraining workshops in a purposeful manner could help minimize errors in selecting and applying pen-and-paper OMs.

Cenobamate is a new antiseizure medication (ASM) recently introduced in the USA for the treatment of adults with focal-onset seizures. In March 2021, the European Commission authorized its use for the adjunctive treatment of focal-onset seizures with or without secondary generalization (focal seizures with or without progression to bilateral tonic-clonic seizures, according to current ILAE terminology) in adults with epilepsy not adequately controlled despite the treatment with at least two ASMs. This review summarizes the mechanism of action, efficacy, and safety of Cenobamate. The authors provide their expert opinions on the use of this drug. The aim of this paper is to report on the Italian preliminary experience with the use of cenobamate, focusing on treatment goals, optimal dosing and titration schedules, strategies to minimize adverse effects, and identification of suitable candidates for treatment. There was agreement that slow titration may improve tolerability, and that clinically significant benefit can be achieved in many patients at relatively low doses. A favorable response to relatively low doses of cenobamate could be an early predictor of ultimate responsiveness. Overall, cenobamate is a welcome new treatment for adults with focal seizures resistant to conventional ASMs.

Introduction: Lithium treatment is considered the gold standard for the long-term management of bipolar disorder and recurrent unipolar depression. It is also extremely effective in other psychiatric conditions characterized by impulsivity and aggression, and for the prevention of suicidal behaviours. Areas covered: This paper provides a scoping review and an expert commentary regarding the use of lithium in adult patients. Available information about efficacy, tolerability, dosing, and switching is analyzed, and the strategies that may be most useful in real-world clinical settings are highlighted. Expert opinion: Lithium is effective on different domains of bipolar disorder, including the long-term prevention of recurrences of affective episodes, management of acute mania as well as in the prophylaxis of all affective episodes. Lithium has been defined a 'forgotten drug,' since its use in routine clinical practice has been declined over the last 20 or 30years. Reasons for this trend include lack of adequate training on the management of lithium side effects. Considering its efficacy, use of lithium in ordinary clinical practice should be promoted. Several strategies, such as using slow-release formulations, can be easily implemented in order to minimize lithium side effects and improve its tolerability profile.

In reaction to the Covid-19 pandemic, the Chinese authorities have installed visa restrictions and strict quarantine rules to prevent foreigners from spreading new infections to the country. This has disrupted a trend of increasing European Union (EU)-China travel and socio-economic exchanges. EU citizens living in or travelling to China have had to deal with the consequences of Beijing’s so-called Zero-Covid strategy. In view of quasi-closed borders, many Europeans have given up on living in or travelling to China. Those who have stayed have come up with strategies of adaptation, while European-owned firms have reacted by adopting initiatives such as doing business online or localising staff. Overall, the Chinese visa restrictions have added a new dimension to the debate on asymmetries in EU-China relations.