Professional quality of life of adult protective service workers

Adult Protective Services (APS) workers are exposed to substantial occupational hazards and job stress, but these stressors are underdocumented. Therefore, we sought to describe APS workers’ work environments and responses to occupational hazards and stressors, including compassion fatigue, burnout, and secondary traumatic stress. Survey data were gathered with closed-ended questionnaires administered to APS workers in an urban setting. Virtually all workers (97%) reported exposure to one or more environmental hazards in their work, and 80% reported hazard exposure in the past month. Workers also reported mixed responses to their work environment and to experiences with supervision. A sizable minority (22.7%) was at high risk for burnout, 24.6% were at risk for secondary traumatic stress, and 19.9% reported low compassion satisfaction. The results document multiple stressors in APS work. The APS partner is committed to ongoing efforts to better support its staff, and these findings can inform future efforts to enhance supervisor support and worker self-care, to minimize burnout and secondary traumatic stress.     

The economy of risk and respect: accounts by Puerto Rican sex workers of HIV risk taking

Three-hundred-eleven female drug-using sex workers in urban Puerto Rico were asked to describe their last negotiation with a client. They described efforts to protect themselves from many hazards of sex work, including violence, illness, and drug withdrawal. They also described efforts to minimize the stigma and marginalization of sex work by cultivating relationships with clients, distinguishing between types of clients, and prioritizing their role as mothers. Sex workers adopted alternating gender roles to leverage autonomy and respect from clients. Their narratives suggest that sex workers negotiate a world in which HIV is relative to other risks, and in which sexual practices which are incomprehensible from an HIV-prevention perspective are actually rooted in a local cultural logic. Future HIV prevention efforts should frame condom use and other self-protective acts in terms that build upon sex workers own strategies for understanding their options and modifying their risks.     

The economy of risk and respect: Accounts by Puerto Rican sex workers of HIV risk taking

Three‐hundred eleven female drug‐using sex workers in urban Puerto Rico were asked to describe their last negotiation with a client. They described efforts to protect themselves from many hazards of sex work, including violence, illness, and drug withdrawal. They also described efforts to minimize the stigma and marginalization of sex work by cultivating relationships with clients, distinguishing between types of clients, and prioritizing their role as mothers. Sex workers adopted alternating gender roles to leverage autonomy and respect from clients. Their narratives suggest that sex workers negotiate a world in which HIV is relative to other risks, and in which sexual practices which are incomprehensible from an HIV‐prevention perspective are actually rooted in a local cultural logic. Future HIV prevention efforts should frame condom use and other self‐protective acts in terms that build upon sex workers' own strategies for understanding their options and modifying their risks.     

Mending broken hearts: marriage and survival following cardiac surgery

Marriage has long been linked to lower risk for adult mortality in population and clinical studies. In a regional sample of patients (n = 569) undergoing cardiac surgery, we compared 5-year hazards of mortality for married persons with those of widowed, separated or divorced, and never married persons using data from medical records and psychosocial interviews. After adjusting for demographics and pre- and postsurgical health, unmarried persons had 1.90 times the hazard of mortality of married persons; the disaggregated widowed, never married, and divorced or separated groups had similar hazards, as did men and women. The adjusted hazard for immediate postsurgical mortality was 3.33; the adjusted hazard for long-term mortality was 1.71, and this was mediated by married persons' lower smoking rates. The findings underscore the role of spouses (both male and female) in caregiving during health crises and the social control of health behaviors.     

Social responsibility and work conditions: building a reference label, Démarche T®

Corporate Social Responsibility (CSR) is now considered in large and global companies and the recent publication of the ISO 26000 standard clarifies the targets. Based on our consultancy's experience for fifteen years in ergonomics mainly in French small and medium enterprises, we developed a label to coax and value efforts of companies in dealing with health and safety at the work place as required by ISO 26000 paragraph 6.4. The formal approach of ISO describes what should be achieved but gives no cue on how actual conditions of work should be improved. The label, called Démarche T (ie Process W where W stands for work) aims the management of work conditions as a process, giving visibility and credit to companies for their continuous involvement in the matter. We describe the items and processes that are part of our assessment. We first conduct an ergonomic diagnosis including the analysis of records on health, physical and psychological well-being, observations at the workplace and interviews with the workers. This diagnosis is followed by recommendations. The fulfillment of these is assessed yearly. Items under assessment include: - ergonomics, health and safety in the companies statements and their impact in actual project management; - relations with workers through the committee for health and safety; - actual results on health, safety and work conditions. On a local level, we give the companies passing the label a competitive edge in recruiting better candidates motivated by good work conditions, and help them fulfill ISO 26000 requirements, an increasingly decisive advantage to benefit from public regional and European support. Our paper describes the diagnosis and follow-up process.     

Elevating financial capability in child welfare services: Early efforts in the Grand Challenge

The great majority of families involved in the child welfare system are economically vulnerable, have limited incomes, and face a high risk of financial exploitation. Limited opportunities to participate meaningfully in the financial sector, along with poor decision making, can lead to overwhelming debt, eviction, and poverty that compromise child safety and wellbeing and can cripple efforts to reunify families. This article discusses the need to elevate financial capability–which scholars and practitioners define as knowledge of financial matters and means to exercise that knowledge. It addresses nascent research examining financial capability and asset building, the expanding role of the topic in human services, and efforts in Missouri to integrate an understanding of financial capability in work with families involved in the child welfare system. Such integration holds the promise of fulfilling the safety, permanence, and wellbeing goals of the child welfare system; involving a wider set of community partners; and achieving the federally mandated ‘normalcy’ in foster care.     

Hazard identification and pre-map with a simple specific tool: synthesis of application experience in handicrafts in various productive sectors

In August 2009, an international group was founded with the task of developing a "toolkit for MSD prevention" under the IEA and in collaboration with the World Health Organization.According to the ISO standard 11228 series and the new Draft ISO TR 12259 "Application document guides for the potential user", our group developed a preliminary "mapping" methodology of occupational hazards in the craft industry, supported by software (Excel?, free download on: www.epmresearch.org).The possible users of toolkits are: members of health and safety committees; health and safety representatives; line supervisors; foremen; workers; government representatives; health workers providing basic occupational health services; occupational health and safety specialists.The proposed methodology, using specific key enters and quick assessment criteria, allows a simple ergonomics hazards identification and risk estimation to be made. It is thus possible to decide for which occupational hazards a more exhaustive risk assessment will be necessary and which occupational consultant should be involved (occupational physician, safety engineer, industrial hygienist, etc.).The methodology has been applied in different situations of small and medium craftsmanship Italian enterprises: leather goods, food, technical dental work, production of artistic ceramics and stained glass, beekeeping activities. The results are synthetically reported and discussed in this paper.     

Negotiations,Work Objects,and the Unborn Patient: The Interactional Scaffolding of Fetal Surgery

This article examines the interactional scaffolding of fetal surgery, an emergent medical specialty focused on the unborn patient. Drawing on work in symbolic interaction, especially that of Mead and Strauss, the article focuses on the social organization of work in a Fetal Treatment Unit at an urban teaching hospital. The major types of interactions among participants are cooperation and conflict, illustrating the many differences among actors in this social world and their need to work together to successfully build their specialty. Differences discussed in this article center on the work object in fetal surgery (who is considered the patient?), criteria for patient selection, and definitions of disease and treatment. Actors must continually negotiate these and other differences as they create the social order of fetal surgery in a politicized context, both locally at Capital Hospital and for the specialty more generally.     

Ergonomic considerations in school environments - the need for widening the scope

Behaviour patterns specific to children pose them at greater risk of environmental hazards than adults. Ergonomics is the science of matching human interaction with the proximate environment. Conventionally ergonomic principles were applied on adult work places to ensure safety of the working environment. With emerging scientific evidence, school environments are being a focus to apply ergonomic principles. Children spend more time within schools during critical developmental stages of their life. Everybody feels that the schools are safe places, but they are not. A multitude of ergonomic hazards have been identified in school settings. Widespread mismatches between anthropometry and school furniture, heavy schoolbag carriage and unhealthy bag behaviour are significant. Negative effects range from general tiredness, musculoskeletal pains, spinal deviations, shoulder level shifts, injuries and psychological disturbances. There are fragmented efforts to widen ergonomic concepts to health care professionals and other stakeholders of child health. Addressing ergonomic issues will ensure that children, the future productive generation contributing to economic growth and development of a country, are provided with opportunities in a healthy environment. This paper emphasizes the need for a concerted effort on widening the scope of ergonomics to cater for the evolving demand.     

Designing out vulnerability, building in respect: violence, safety and sex work policy

One recent finding about the prostitution market is the differences in the extent and nature of violence experienced between women who work on the street and those who work from indoor sex work venues. This paper brings together extensive qualitative fieldwork from two cities in the UK to unpack the intricacies in relation to violence and safety for indoor workers. Firstly, we document the types of violence women experience in indoor venues noting how the vulnerabilities surrounding work-based hazards are dependent on the environment in which sex is sold. Secondly, we highlight the protection strategies that indoor workers and management develop to maintain safety and order in the establishment. Thirdly, we use these empirical findings to suggest that violence should be a high priority on the policy agenda. Here we contend that the organizational and cultural conditions that seem to offer some protection from violence in indoor settings could be useful for informing the management of street sex work. Finally, drawing on the crime prevention literature, we argue that it is possible to go a considerable way to designing out vulnerability in sex work, but not only through physical and organizational change but building in respect for sex workers rights by developing policies that promote the employment/human rights and citizenship for sex workers. This argument is made in light of the Coordinated Prostitution Strategy.     

Addressing intimate partner violence in primary care: lessons from chronic illness management

Though many studies have documented the high prevalence, morbidity, mortality and costs attributable to intimate partner violence (IPV), it is still unclear how our health care system should address this major public health problem. Many have advocated for routine screening, yet there is still insufficient evidence that routine IPV screening can lead to improved outcomes. Though recognition of IPV is very important, a screening paradigm may not be the optimal way to approach IPV within the health care system. For many patients, exposure to violence is a chronic condition, characterized by long-term abusive relationships, histories of childhood and community violence, multiple associated chronic symptoms, and extra barriers to addressing their other chronic illnesses. Thus, there may be important lessons to be learned from work being done in the area of chronic care. We explore how Wagner's Chronic Care model may guide efforts to improve health care for IPV survivors and may serve as a framework for future research studies.     

How are nurses at risk?

The effectiveness of occupational health and safety management systems (OHSMS) can be understood through analysis of surveys such as the experiences of exposure to occupational hazards by Australian nursing occupations. How effectively OHSMS are implemented in the Australian health industry is unclear as few studies describe current hazard exposure patterns or the impact of OHSMS in the Australian health industry. This paper concludes from the analysis of an Exposure Survey of Australian nursing occupations that nursing occupations perceive themselves to be "at risk" of injury and/or management of OHS risk in work duties is affected by the patterns of hazard exposure, occupation group as well as employee attributes, perceptions, patterns and situations of work. The results highlight the top-rated hazards and imply that the perceptions of hazards in the workplace are different to actual risk experience (e.g. injury patterns). There is an unacceptable level of exposure to diverse hazards in Australian nursing occupations workplaces in regard to regulatory and performance obligations. Stronger strategies to achieve more effective risk treatment, integrate with hospital accreditation and quality programs are discussed to benefit system performance and the welfare of those in nursing occupations.     

The role of ‘workplace family’ support on worker health,exhaustion and pain

The goal of this study was to improve understanding of the potential health benefits of social support at work. We utilized 2002 GSS data to examine the relative influence of workplace support on self-reported health, exhaustion and experience of persistent pain in a sample of 1602 workers. Building on previous Demand-Control-Support models, we examined co-worker, supervisor, and organizational safety support (conceptualized as ‘workplace family’) in concert with job demands, job control and work-family conflict as predictors of worker health measures. We further tested the extent to which work-family conflict acted as a mediator between family and work characteristics and worker health outcomes. We found that increased co-worker support in the workplace was associated with better worker self-reported health, lower exhaustion and less pain. In addition, higher levels of perceived organizational safety support were associated with better self-reported health and lowered exhaustion. There is little evidence that work-family conflict mediates between work and family characteristics and worker health, and work-family conflict does not mediate the relationship between workplace family measures and worker health. We discuss results in light of workers’ changing and expanding definitions of family, with implications for changes in the organization of the workplace to improve workers’ health.     

Reducing latent errors, drift errors, and stakeholder dissonance

Healthcare information technology (HIT) is being offered as a transformer of modern healthcare delivery systems. Some believe that it has the potential to improve patient safety, increase the effectiveness of healthcare delivery, and generate significant cost savings. In other industrial sectors, information technology has dramatically influenced quality and profitability - sometimes for the better and sometimes not. Quality improvement efforts in healthcare delivery have not yet produced the dramatic results obtained in other industrial sectors. This may be that previously successful quality improvement experts do not possess the requisite domain knowledge (clinical experience and expertise). It also appears related to a continuing misconception regarding the origins and meaning of work errors in healthcare delivery. The focus here is on system use errors rather than individual user errors. System use errors originate in both the development and the deployment of technology. Not recognizing stakeholders and their conflicting needs, wants, and desires (NWDs) may lead to stakeholder dissonance. Mistakes translating stakeholder NWDs into development or deployment requirements may lead to latent errors. Mistakes translating requirements into specifications may lead to drift errors. At the sharp end, workers encounter system use errors or, recognizing the risk, expend extensive and unanticipated resources to avoid them.     

Advances in the surgical management of prolapse

Prolapse is an extremely common condition, for which 11% of women will have a surgical procedure at some point in their lives. The recurrence rate after most of the traditional surgical procedures is high and upto 29% of women who have had surgery for prolapse will require a further operation. In order to improve the surgical outcome, there is currently much interest in the use of grafts to augment traditional repairs and new procedures have been developed using specifically developed grafts. These have been combined with minimally invasive surgical techniques in an attempt to reduce surgical morbidity. These procedures may improve the outcome of surgery for prolapse. However, there is currently a lack of long-term data from randomized trials to demonstrate their effectiveness and safety.     

以人为本努力推进实事化维权上台阶——记陕西省妇联特色维权工作

近年来,陕西省妇联坚持以人为本,积极回应妇女儿童维权需求,在实事化维权上下功夫．不断强化维权服务手段,拓展维权服务内容,提升维权服务水平,形成了常态化、规范化的法律援助、心理帮扶、医疗救助等工作机制,更加切实地维护了妇女儿童的合法权益,化解了社会矛盾。     

Complexity analysis of the Next Gen Air Traffic Management System: trajectory based operations

According to Federal Aviation Administration traffic predictions currently our Air Traffic Management (ATM) system is operating at 150 percent capacity; forecasting that within the next two decades, the traffic with increase to a staggering 250 percent [17]. This will require a major redesign of our system. Today's ATM system is complex. It is designed to safely, economically, and efficiently provide air traffic services through the cost-effective provision of facilities and seamless services in collaboration with multiple agents however, contrary the vision, the system is loosely integrated and is suffering tremendously from antiquated equipment and saturated airways. The new Next Generation (Next Gen) ATM system is designed to transform the current system into an agile, robust and responsive set of operations that are designed to safely manage the growing needs of the projected increasingly complex, diverse set of air transportation system users and massive projected worldwide traffic rates. This new revolutionary technology-centric system is dynamically complex and is much more sophisticated than it's soon to be predecessor. ATM system failures could yield large scale catastrophic consequences as it is a safety critical system. This work will attempt to describe complexity and the complex nature of the NextGen ATM system and Trajectory Based Operational. Complex human factors interactions within Next Gen will be analyzed using a proposed dual experimental approach designed to identify hazards, gaps and elicit emergent hazards that would not be visible if conducted in isolation. Suggestions will be made along with a proposal for future human factors research in the TBO safety critical Next Gen environment.     

农村留守女童性安全与性教育问题

近年来，随着外出务工人员的日益增多，农村留守女童数量也急剧上升。由于缺乏必要的监护及性安全教育，不少留守女童成为性侵害的对象。农村留守女童性安全与性教育问题成为舆情分析的焦点。从留守女童性侵案件呈现出的三大特征，即性侵主体多元化、性侵手段多样化、性侵意识淡漠化，可以看出农村留守女童性安全问题情势不容乐观。究其原因，突出地表现在三个方面：亲子教育的缺失影响到性知识的传授、监护人缺乏性安全防范与教育的意识以及学校性安全教育的重视力度较为薄弱。因此，要整合学校、家庭和社会力量，对农村留守女童系统而科学地实施性安全教育，以期能够促进她们身心健康和谐发展。     

Environmental Justice and Social Work Education: Social Workers' Professional Perspectives

Environmental injustice is a growing human rights issue as climate change and environmental degradation rapidly increases. As a social justice problem, it is relevant to the social work profession, yet not integrated into our curricula. This study of 373 social work professionals found that environmental justice is a significant practice issue across broad client populations and that professionals felt unprepared to address it. Qualitative and quantitative data revealed high levels of client exposure to environmental hazards with little power to change it. Respondents reported dissatisfaction with their education to help them understand environmental issues. Moreover, they indicated that they would like to see environmental justice integrated into social work education and better-prepared graduates entering the profession. Implications for practice and education are discussed.     

Interventions to improve patient safety in transitional care--a review of the evidence

When a patient's transition from the hospital to home is less than optimal, the repercussions can be far-reaching - hospital readmission, adverse medical events, and even mortality. Elderly, especially frail older patients with complex health care problems appear to be a group particularly at risk for adverse events in general, and during transitions across health providers in particular. We undertook a systematic review to identify interventions designed to improve patient safety during transitional care of the elderly, with a particular focus on discharge interventions. We searched the literature for qualitative and quantitative studies on the subject published over the past ten years. The review revealed a set of potential intervention types aimed at the improvement of communication that contribute to safe transitional care. Intervention types included profession-oriented interventions (e.g. education and training), organisational/culture interventions (e.g. transfer nurse, discharge protocol, discharge planning, medication reconciliation, standardized discharge letter, electronic tools), or patient and next of kin oriented interventions (e.g. patient awareness and empowerment, discharge support). Results strongly indicate that elderly discharged from hospital to the community will benefit from targeted interventions aimed to improve transfer across healthcare settings. Future interventions should take into account multi-component and multi-disciplinary interventions incorporating several single interventions combined.