提高经济运行质量感言

为深入贯彻落实天津市委八届九次全会、天津市委规划建设工委扩大会议精神,以科学发展观为统领,深刻认识城建集团面临的新形势、新任务,实现施工生产规模与经济效益同步增长,天津城建集团围绕"提高班子驾驭经济工作能力、转变经济增长方式、增强企业发展信心、提高创效能力和加强资产管理"五个专题,进行了广泛深入的经济工作大讨论.目前,大讨论虽已告一段落,但讨论所引发的思考却远没有结束.笔者对此感触有三:     

Using process evaluation to determine effectiveness of participatory ergonomics training interventions in construction

The construction industry continues to experience high rates of musculoskeletal injuries despite the widespread promotion of ergonomic solutions. Participatory ergonomics (PE) has been suggested as one approach to engage workers and employers for reducing physical exposures from work tasks but a systematic review of participatory ergonomics programs showed inconclusive results.. A process evaluation is used to monitor and document the implementation of a program and can aid in understanding the relationship between the program elements and the program outcomes. The purpose of this project is to describe a proposed process evaluation for use in a participatory ergonomic training program in construction workers and to evaluate its utility in a demonstration project among floor layers.     

The role of need for contraception in the evaluation of interventions to improve access to family-planning methods

A nonrandomized experiment carried out in Jharkhand, India, shows how the effects of interventions designed to improve access to family-planning methods can be erroneously regarded as trivial when contraceptive use is utilized as dependent variable, ignoring women's need for contraception. Significant effects of the intervention were observed on met need (i.e., contraceptive use by women who need contraception) but not on contraceptive use (i.e., contraceptive use by women who may or may not need contraception). Met need captures the woman's success in overcoming barriers to access to family planning, whereas contraceptive use confounds this construct with risk of pregnancy and fertility desires. Exceptions to this rule are identified.     

An evaluation of collaborative interventions to improve chronic illness care. Framework and study design

The author's dual-purpose evaluation assesses the effectiveness of formal collaboratives in stimulating organizational changes to improve chronic illness care (the chronic care model or CCM). Intervention and comparison sites are compared before and after introduction of the CCM. Multiple data sources are used to measure the degree of implementation, patient-level processes and outcomes, and organizational and team factors associated with success. Despite challenges in timely recruitment of sites and patients, data collection on 37 participating organizations, 22 control sites, and more than 4,000 patients with diabetes, congestive heart failure, asthma, or depression is nearing completion. When analyzed, these data will shed new light on the effectiveness of collaborative improvement methods and the CCM.     

Metabolic and hormonal responses to different resistance training systems in elderly men

Objective: To compare acute and sub-acute responses in hormonal profile and metabolic parameters in elderly people who participated in two methods of strength training (ST) with equalized loads.

Methods and materials: A total of 12 elder individuals (65?±?3 years) were randomly assigned to two training methods: constant intensity (CI, 3 sets of 10 repetitions with 75% of 1RM) and variable intensity (VI, 1st set: 12 repetitions at 67% of 1RM?>?2nd set: 10 repetitions at 75% of 1RM and 3rd set: 8 repetitions at 80% of 1RM). Both methods included the following exercises: leg press, knee extension, and squat with 1?min rest intervals between sets. Free speed of execution and maximum range of movement were encouraged throughout each set for both protocols. Blood samples were analyzed included glucose, testosterone (T), cortisol (C), T/C rate, growth hormone (GH), and lactate at 2 and 24?h post intervention.

Results: There were no observed differences in glucose, testosterone, GH, and lactate concentrations both at 2 and 24?h after the execution of the two training methods. However, significant increases in the levels of T/C rate and decrease on cortisol were observed immediately post exercise for both protocols.

Conclusions: Although no significant differences were observed between the two interventions in relation to the hormonal and metabolic parameters analyzed, both training methods promoted a favorable response, with a slight superiority noted for the CI method relative to the hormonal profile.     

A systematic review of interventions to improve post-secondary educational outcomes among foster care alumni

In their transition to adulthood, youth who have aged out of foster care struggle in a variety of areas. One area of concern is achieving success in post-secondary education. In response, universities and community colleges around the country offer support programs for these youth, in order to assist them in gaining a college education. The purpose of this study was to utilize a systematic review process to uncover the current status of what is known about campus support programs for foster care alumni in two areas—student views of their program experiences and outcomes of interventions to improve post-secondary educational success. We adapted the Participants, Interventions, Comparison groups, Outcomes, and Study designs (PICOS) model in conducting the systematic review. A search of six electronic databases and other gray literature sources yielded seven articles. Results revealed valuable insight from students regarding the ways in which program implementation was beneficial, and highlighted important strategies future programs should consider. Further, findings of outcome studies are favorable. However, additional outcome evaluations are needed in order to validate and confirm their impact.     

How to improve gait and balance function in elderly individuals—compliance with principles of training

Most balance training regimens for elderly individuals focus on self-controlled exercises, although automatic postural responses after a balance perturbation are not under direct volitional control. We critically review the literature on this topic, and notice that several studies fail to comply with basic principles of training and therefore show little improvement in function. Some present the view that physical function in the too frail and too fit cannot be improved, which we instead argue would be the effect of nonspecific training programs. We propose a concept for balance training that incorporates voluntary exercises as well as perturbation and dual-task exercises to improve balance control. The program is performed on five different levels where levels 1–4 exercises focus on the skill to maintain balance and level 5 adds perturbation exercises that focus on the skill to recover balance as well as dual task exercises providing a cognitive load during execution of a balance motor task. Functional requirements for muscle strength and power are directly incorporated into the program. The feasibility of the concept has been demonstrated on elderly fallers. A randomized control trial is underway to investigate the effects on healthy elderly individuals. Further intervention studies using this concept are encouraged.     

Measurement and evaluation practices of factors that contribute to effective health promotion collaboration functioning: A scoping review

The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation practices. Measurement approaches and evaluation practices employed in 14 English-language articles published between January 2001 and October 2015 were considered. Data extraction included research design, health focus of the collaboration, factors being evaluated, how factors were conceptualized and measured, and outcome measures. Studies were methodologically diverse employing either quantitative methods (n = 9), mixed methods (n = 4), or qualitative methods (n = 1).In total, these 14 studies examined 113 factors, 88 of which were only measured once. Leadership was the most commonly studied factor but was conceptualized differently across studies. Six factors were significantly associated with outcome measures across studies; leadership (n = 3), gender (n = 2), trust (n = 2), length of the collaboration (n = 2), budget (n = 2) and changes in organizational model (n = 2). Since factors were often conceptualized differently, drawing conclusions about their impact on collaborative functioning remains difficult. The use of reliable and validated tools would strengthen evaluation of health promotion collaborations and would support and enhance the effectiveness of collaboration.     

Anabolic responses to resistance training in older men and women: a brief review

Resistance training has been shown to be the most effective exercise mode to induce anabolic adaptations in older men and women. Advances in imaging techniques and histochemistry have increased the ability to detect such changes, confirming the high level of adaptability that remains in aging skeletal muscle. This brief review presents a summary of the resistance-training studies that directly compare chronic anabolic responses to training in older (>60 years) men and women. Sixteen studies are summarized, most of which indicate similar relative anabolic responses between older men and women after resistance training. Relatively small sample sizes in most of the interventions limited their ability to detect significant sex differences and should be considered when interpreting these studies. Future research should incorporate larger sample sizes with multiple measurement time points for anabolic responses.     

Fatigue management by truck drivers in real life situations: some suggestions to improve training

Truck driver fatigue is a major safety issue for truck drivers and the public in general. Although training prepares drivers to effectively operate a truck, it tends to minimize the importance of working constraints faced daily on-the-job and thus reduces its impact on safety and effectiveness. With experience, drivers develop skills to combat fatigue. Documenting these skills can contribute to improved training of apprentices. An ethnographic approach was used to better understand the real-life fatigue management skills of truck drivers. Participant observation was used to analyze the activity of apprentices in training and the activity of truck drivers at work. Observations indicated that training focused on time management and regulations, but did not prepare trainees to manage real-life constraints. Experienced drivers were not merely managing time; rather they were managing working constraints (including time) as a whole. To do so, they used two strategies: managing psycho-physical transformations and dynamic work planning. By integrating psycho-physical preoccupations into all aspects of work and by preparing future drivers to face real-life constraints, we could better train and prepare apprentices. Drivers do develop effective skills to combat fatigue which can improve training and better prepare future drivers to face daily constraints. These improvements can have a significant impact on fatigue and safety in the transportation industry.     

Physical-performance tests to evaluate mobility disability in community-dwelling elders

The purposes of this study were to evaluate community-dwelling elderly adults with different levels of perceived mobility with 5 physical-performance tests, determine the cutoff values of the 5 tests, and identify the best tests for classifying mobility status. The community-mobility statuses of 203 community-dwelling elders were classified as able, decreased, or disabled based on their self-reported ability to walk several blocks and climb stairs. They also performed the functional reach, timed 50-ft walk, timed 5-step, timed floor transfer, and 5-min-walk endurance tests. We found in all tests that the "able" outperformed the "decreased" and that the "decreased" outperformed the "disabled," except on the floor-transfer task. The optimum cutoff values of the 5 performance tests were also reported. The 5-min walk and timed 5-step test could best separate the "able" from the "decreased," whereas the 50-ft-walk-test could best differentiate the "decreased" from the "disabled." The results suggest that community-mobility function of older adults can be captured by performance tests and that the cutoff values of the 5-min-walk, 5-step, and 50-ft-walk tests can be used in guiding intervention or prevention programs.     

Clergy training for effective response to intimate partner violence disclosure: Immediate and long-term benefits

ABSTRACT

This study reports findings from an intimate partner violence-training project in which 104 Seventh-Day Adventist pastors received a 4-hr training in responding effectively to intimate partner violence (IPV) disclosure. The educational endeavor targeted three areas for improvement in clergy response: (a) increasing pastors’ understanding of the unique dynamics in abusive relationships, (b) providing information on IPV resources and services, and (c) developing pastors’ abilities and motivations to be proactive in addressing IPV. Pretest, posttest and 1-year follow up data indicate that pastors who engaged in IPV training demonstrated immediate and long-term positive changes. Specifically, participants showed improvements in each of the targeted areas. Beyond the gains in knowledge and attitudes about IPV, the study results also indicate that pastors receiving training expanded their activities to positively address IPV in their congregations. Social workers can play a significant role in addressing clergy training needs by strengthening pastors’ abilities to respond appropriately to parishioners’ IPV disclosures.