The effect of ergonomic intervention on neck/shoulder and low back pain

The aim of this study was to examine the effect of two types of ergonomic intervention on pain and pain-related disability in the neck/shoulder and low back regions. A cohort of 492 subjects of various occupations with non-specific neck/shoulder or low back pain was followed over a five to six year period. The study subjects were classified into four intervention groups: no ergonomic intervention, educational worksite intervention, workplace intervention, and combined workplace and educational worksite intervention. The group with no ergonomic intervention was used as the reference group. The changes in pain intensity and pain-related disability from baseline to follow-up in each of the three groups with intervention were compared to the changes in the reference group. During the follow-up, 39% of the subjects had received ergonomic intervention. The average change in pain intensity and pain-related disability was smaller in the educational worksite intervention group than in the reference group. The average reduction of pain intensity and pain-related disability did not differ between the two other intervention groups and the reference group. Thus, for subjects still at work, ergonomic intervention seemed to be ineffective for reducing neck/shoulder and low back pain and pain-related disability.     

Target groups for prevention of neck/shoulder and low back disorders: an exploratory cluster analysis of working and living conditions

Musculoskeletal disorders (MSDs) have a multifactorial etiology. Therefore, a holistic approach to identifying target groups for primary/secondary prevention is essential. In this study, an exploratory person-oriented approach was applied, using cluster analysis of variables related to physical and psychosocial work conditions, and conditions in the private sphere, on a data set of 1,341 Swedish women and men who had not sought care for MSDs the 6 months preceding enrollment in the study. Three groups at risk and five "healthy" groups regarding MSDs were identified. Two of the risk groups had a strained situation regarding psychosocial work conditions or domestic/family conditions, respectively. The majority of individuals in these groups were women. The third risk group had a strained situation regarding both physical and psychosocial work conditions. This group consisted largely of men working in male-dominated jobs. The five healthy groups had low/moderate metabolic demands at work, and all of them having high proportions of subjects with moderate to high education, and fairly even distributions of men and women. In conclusion, the results indicate that gender-specific working and living conditions are associated with an increased risk for MSDs. The identification of these subgroups in the population may facilitate a selective prevention approach.     

Assessment of recovery in older patients hospitalized with different diagnoses and functional levels,evaluated with and without geriatric assessment

Background

The objective of the present study was to investigate 1) the role of different admission diagnoses and 2) the degree of functional loss, on the rate of recovery of older patients after acute hospitalization. Furthermore, to compare the predictive value of simple assessments that can be carried out in a hospital lacking geriatric service, with assessments including geriatric screening tests.

Methods

Prospective, observational cohort study, including 961community dwelling patients aged?≥?70 years, transferred from medical, cardiac, pulmonary and orthopedic acute hospital departments to intermediate care in nursing home. Functional assessment with Barthel index (BI) was performed at admission to the nursing home and further geriatric assessment tests was performed during the first week. Logistic regression models with and without geriatric assessment were compared concerning the patients having 1) slow recovery (nursing home stay up to 2 months before return home) or, 2) poor recovery (dead or still in nursing home at 2 months).

Results

Slow recovery was independently associated with a diagnosis of non-vertebral fracture, BI subgroups 50–79 and <50, and, in the model including geriatric assessment, also with cognitive impairment. Poor recovery was more complex, and independently associated both with BI?<?50, receiving home care before admission, higher age, admission with a non-vertebral fracture, and in the geriatric assessment model, cognitive impairment.

Conclusions

Geriatric assessment is optimal for determining the recovery potential of older patients after acute hospitalization. As some hospitals lack geriatric services and ability to perform geriatric screening tests, a simpler assessment based on admission diagnoses and ADL function (BI), gives good information regarding the possible rehabilitation time and possibility to return home.

     

Futurelessness,migration, or a lucky break: narrative tropes of the ‘blocked future’ among Serbian high school students

ABSTRACT

This article uses ethnographic discourse analysis to understand how Serbian high school students at ‘Belgrade Professional’ (BP) respond to coursework and discussions about their individual futures. Contextualizing the conversations at BP within broader local and international social forces, the paper shows how students’ perceptions of their future chances are mediated by both the school’s outdated promises of secure skilled employment and a broad understanding of Western liberal democracies as ‘meritocratic’. In short, I argue that BP students recognize the elective ‘choice biography’ as a real pathway to adulthood. However, they primarily imagine the choice biography as existing outside of Serbia, while feeling constrained by – even hostile to – such an idea within the country. To counter choice biography framings of futures in Serbia, students mobilize a discourse I call the ‘blocked future’, comprised of three related narrative tropes informed by the decades-long recession: domestic futurelessness, meritocracy abroad, and local chance. These narrative tropes illuminate the emerging cultural structures in Serbia which reflect how people cope with and processes the conflicting structural demands and unfulfilled promises of the post-socialist transition in everyday life.     

A comparison of self-perceived physical and psycho-social worker profiles of people with direct work injury, chronic low back pain, and cumulative trauma

This study investigated the psycho-social factors among injured workers and the influence of their psycho-social profile on the readiness of return to work. Sixty-four subjects with injuries on the upper limbs or lower limbs, low back pain, or cumulative trauma disorder were recruited. The workers' profiles (self-perceived physical health, mental health, and work readiness) together with the impact and types of work injury on the workers' perceived wellness were measured. The regression model of work readiness was constructed to develop a theoretical background for predicting work readiness based on different factors. The results showed that injured workers with chronic injury such as low back pain or cumulative trauma had poorer self-perception of physical health and psycho-social/mental health compared to those with direct trauma. The regression analysis further affirmed that self-perceived pain and physical functioning were significant factors influencing the readiness for returning to work. Workers with low back pain were found to have lower motivation for returning to work. Other factors such as the non-verbal intelligence of the injured workers, their anxiety level, and the support they received from family members were found to have some indirect impact on their ability to return to work, but this was not statistically proven.     

Parents,services and system: an exploration of power dynamics in future planning among parent carers for people with disability

Interactions between services and families have significant implications for families planning for the future needs of a family member who has a disability. However, little research interrogates the implications of these relationships for parent carers’ agency in this planning. This qualitative study explored parents’ experiences with public and not-for-profit services during planning. Findings revealed varied and fluid power dynamics, with attempts by carers to shift to more productive power relations, which carried risks and costs. In a context characterised by systemic constraints, these shifts create an iterative planning process, and highlight the need to support parents to use power productively.     

No Longer “One of the Boys”: Negotiations with Motherhood,as Prospect or Reality,among Women in Engineering*

La maternité est généralement considérée comme constituant un tournant dans la carrière des femmes professionnelles, particulièrement chez celles qui occupent des emplois à prédominance masculine. S'inspirant de la documentation dans le domaine des femmes et du travail non traditionnel, l'auteure de cet article tente d'expliquer la signification critique de la maternité, antieipée ou réelle, pour les femmes travaillant dans le domaine de l'ingénierie. Elle va au‐delà des arguments plus conventionnels sur l'équilibre travail‐famille en suggérant que les femmes entreprennent une carrière en génie non en tant que femmes, mais conceptuellement comme des hommes – un statut qu'elles peuvent trouver difficile à conserver en tant que mères. Le défi pour celles qui deviennent effectivement mères est alors de gérer la tension découlant de l'obligation d'équilibrer deux identités potentiellement incompatibles – celle de«mère» et celle d'« ingénieure ». Cette conception est étudiée empiriquement au moyen de données d'interviews de 37 femmes formées comme ingénieures. Motherhood is widely considered to be a watershed in the careers of professional women, particularly those working in male‐dominated occupations. Building on the literature in the field of women and non‐traditional work, this paper seeks to account for the critical significance of motherhood, either anticipated or actual, for women in engineering. The paper moves beyond more conventional work‐family balance arguments in suggesting that women enter engineering not as women, but conceptually as men–a status that, as mothers, they may find difficult to maintain. The challenge for those who do become mothers, then, is to manage the tension of balancing two potentially incongruous identities–“mother” and “engineer.” This view is explored empirically through interview data from 37 women trained as engineers.