IEA/WHO toolkit for WMSDs prevention: criteria and practical tools for a step by step approach

When studying WMSDs, several determinants and their interrelationship are considered as relevant. Hence the necessity of an "holistic" approach to prevention, especially when preparing technical rules and strategic plans. There is a strong request, from OSH agencies and operators, for developing "simple" tools for risk assessment and management. In this context WHO asked IEA to develop a "Toolkit for WMSD prevention". The paper presents one of the main contribution to this WHO project, focused on selecting tools at different level for hazard identification, risk estimation and management. Proposals are based on two essential criteria: Acting on a step-by-step approach; Taking into account the presence of multiple influencing factors. The proposals consider: A Basic Step devoted to hazard identification by operative "key-enter" questions, that can be operated also by non-experts. A First Step, (quick assessment), for identifying 3 possible conditions: acceptable; high risk present; more detailed analysis (via tools presented at second step) necessary. This step can be operated by non-experts with only some specific training. A Second Step, where recognized (i.e. from international standards or guidelines) tools for risk estimation are used. This step can be operated only by persons with some specific training.     

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.     

Prevention of MSD by means of ergonomic risk assessment (tools) in all phases of the vehicle development process

In industrialized countries musculoskeletal disorders (MSD) play an import role and are often responsible for almost one third of the total sick leave. The changes in the demographic profiles, i.e. aging work forces might even worsen this situation in the future. For a highly productive and sustainable use of human resources in production systems, ergonomics offers high potentials. In the recent years the authors have developed several ergonomic risk assessment tools, especially for the use in automotive industries. These methods may be used during the planning phases in the Tech Centers as well as during the production phase at shop floor level. The tools might also be used for a standardized communication in between the Tech Center and the plants to improve the effects of "lessons learned" for the design and layout of workstations and processes and the optimization of vehicle components. This paper describes suitable risk assessment tools as well as the integration of these tools into the vehicle development process. It introduces a comprehensive management approach for the integration of ergonomics into the management of production systems.     

Systemic differences in views on risk: A comparative case vignette study of risk assessment in England,Norway and the United States (California)

This article examines how child welfare workers from three countries assess risk to a child in the context of different risk assessment tools, child welfare systems and welfare regimes. Previous research suggests that there are distinct differences between child protection-oriented child welfare systems such as England and the U.S., and family service-oriented child welfare systems such as Norway (Gilbert et al., 2011). We use a case vignette method to analyze how 299 child welfare workers from England, Norway and California (U.S.) assess risk. The case vignette describes the case of ‘Beatrice’, a nine year-old girl of Black African descent who was born with an organic heart disease and a cleft palate. We found that respondents from California assessed the risk to be the lowest, followed by respondents from England and Norway. The risk factors that respondents highlighted as important for their assessment also varied significantly between countries, displaying different perceptions of elements in a case constituting risk. Respondents from Norway, who, comparatively, practice within the context of the least regulated assessment platform, identified the most homogenous assessments and types of reasoning, whereas both the assessment of risk levels and identifications of risk factors were more heterogeneous among workers in England and California. We argue that the different risk assessment tools only partly influence what workers identify as risk factors in a case, and that type of welfare states and child welfare systems is also an influence. This study thus supports existing scholarship on the distinctions between child welfare systems. However, we also found significant differences in perceptions of risk factors between England and the United States.     

Participatory ergonomic processes to reduce musculoskeletal disorders: summary of a Québec experience

This article critically reviews 11 participatory ergonomic interventions carried out in Québec by the Occupational Health and Safety Research Institute (IRSST). In the introduction, the characteristics of the approach used are situated in relation to the literature on this subject. Based on the "Ergo team" formula, the approach aims to provide company personnel with the skills to analyze and correct hazardous workstations in relation to musculoskeletal disorders (MSD), using an analysis process that the researchers developed. Although isolated workstations were corrected, the process aims for more general impacts on the company. In the 11 interventions, 40 work situations were analyzed, and in 31 cases, changes were implemented to reduce MSD risks. The most common changes dealt with the tools/equipment (77.4% and physical layouts (84%); changes involving work methods (29% and work organization (12.9%) were less common. The difficulties encountered in the interventions are summarized, and the possible impacts of the interventions on the organization and psychosocial factors are discussed. The authors then address the limitations of the paper and the factors that should be considered in evaluating such a participatory process. The authors conclude that the participatory process was successful in implementing changes in companies and that other studies are necessary for a better understanding of the process and its impacts.     

Fundamentals of systems ergonomics

Ergonomics/human factors is, above anything else, a systems discipline applying a systems philosophy and systems approaches. Many things are labeled as "systems X" in today's world, and this paper specifies just what attributes and notions define ergonomics/human factors in systems terms. These are concern for context, acknowledgement of interactions and complexity, a holistic approach, recognition of emergence and embedding of the professional effort involved within organization systems. These five notions are illustrated with examples from a large body of work on rail human factors.     

Risk assessment in context

This article provides an overview of the context in which decisions about risk are made in child welfare including personal, task, and environmental factors that may contribute to uncertainty and less-than-optimal decision making, as well as some of the methodological challenges posed by the use of current risk assessment instruments. Actuarial, consensus-based, and clinical instruments are discussed and the more successful track record of actuarial decision-making in child welfare and related fields is highlighted. Methodological challenges to assessing risk are also presented including lack of reliability and validity of measures, definitional dilemmas, temporal issues such as changes in risk over time, absence of base rate data, predicting for individuals and sensitivity and specificity of measures. Implications for the design and implementation of risk assessment tools are considered in light of contextual influences and methodological limitations. Lastly, an overview of the contents of Part One of this special issue on risk assessment is provided.     

Oasis in a concrete jungle: arts-informed methods in social work classrooms

This article presents a qualitative arts-informed inquiry on teaching and learning in social work education. Using arts-informed research methodology and grounded theory methodology, the research analyses ten interviews of social work educators in two Canadian provinces. This article focused on how university educators use arts-informed methods of teaching about social justice through anti-racist and decolonizing lenses; also discussed are the educators’ personal and professional transformation and development within this process. The main findings discuss the importance of creating an ‘artful’ space as a platform for experiential, embodied and emotive learning, which offers an innovative, more holistic and comprehensive way of teaching social justice. This way of teaching emphasizes personal transformation, giving space to marginalized voices and expression; as well as collective co-creation of meaning and creating practical tools for future social change. The study also touches upon challenges and gaps in using an arts-informed approach, which include student resistance to alternative ways of education, expressed specifically by racialized educators and ambiguity related to assessing artful works in an academic setting. The paper ends with recommendations for social work education.     

Depression in school-aged children: assessment & early intervention

A careful assessment of all of these factors will help nurse therapists who are also primary care providers develop a more holistic approach to treatment and, thus, increase treatment effectiveness. The three-pronged assessment approach discussed above is cost effective, safe, and indicated as a frontline measure to assess the risk for depression in children and their parents (particularly mothers), which can begin the process of "true" early intervention. I say "true" early intervention because in my role as an early intervention specialist, my first meeting with families usually occurs after a crucial incident requiring hospitalization of the child or the parent, or school failure, or both. My programs of intervention are hardly "early," although treatment is started relatively early in the life of the child. In the past few years, I have noticed that psychiatric-mental health advanced practice nurses, including myself, are increasingly working in some capacity in primary health centers, such as school-based clinics, churches, collaborative practices, and community health centers. It would be wonderful if we used these settings to identify risk for depression in children and begin preventive treatment (starting with teaching good sleep hygiene, a treatment in itself) to truly make early intervention a reality.     

Employer Policy and Practice Toward Older Workers in Hong Kong: The Role of Shifting Intergenerational Dynamics

Many governments are seeking to encourage the extension of working lives to counteract potential labor market shortages that might result from population aging. Nevertheless, research shows that older workers continue to face a range of barriers to their labor market participation. However, this research has not tended to take a holistic view of the factors shaping employer policy and practice or acknowledge that older workers’ experiences are embedded within broader social structures and age dynamics. This article reports on exploratory qualitative research undertaken in Hong Kong. It demonstrates how employer policy and practice toward older workers are shaped by intergenerational dynamics and by the social responsibility that employers feel toward different generations. It is argued that in order to more fully understand employer policy and practice toward older workers, an approach that acknowledges the social context and position of different age groups is required.     

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.     

Gary Becker's Contributions to Family and Household Economics

Gary Becker's influence on the economics of the family has been pervasive. His ideas have dominated research in the economics of the family, shaping the tools we use, the questions we ask, and the answers we give. The foundational assumptions of Becker's economic approach to the family–maximizing behavior and equilibrium–as well as such primary auxiliary assumptions as household production and interdependent preferences, are now widely accepted not only by economists but also by family sociologists, demographers, and others who study the family. Yet the interesting and provocative implications of Becker's economic approach to the family do not follow from the foundational assumptions or from the primary auxiliary assumptions. Instead they depend on contested auxiliary assumptions to which neoclassical economics has no commitment and which lack empirical support. This paper discusses the crucial role of auxiliary assumptions in Becker's analysis of the family, first in the context of preferences, then in the context of household production, and finally in the context of family or household collective choice.     

Methods of Engagement in Family-Based Preventive Intervention

Family-based prevention programs have shown promise in preventing drug use and antisocial behavior in high-risk youth. Multidimensional family prevention (MDFP) is an intensive, family-based counseling program in which a family-specific prevention agenda is crafted with each family. This collaborative, individualized approach to intervention requires a high degree of engagement on the part of families. The main challenges of engagement are discussed, and the main features of an engagement strategy are described: capturing the interest of the family and assessing risk and protective factors within the specific ecological context of the family in order to create a working agenda for preventive intervention.     

SUBSTANCE ABUSE AND SLOW-MOTION DISASTERS: The Case of Detroit

In this article, I focus on problem substance use as one outcome of an underlying, "slow-motion disaster" caused by the long-term collision between corrosive structural processes, counterproductive social policies, and vulnerable populations. Using the city of Detroit as an illustration, I offer an original conceptual model for linking the causes and cascading consequences of slow-motion disasters. This model highlights the embedded connections between structural factors, such as racial segregation and systemic unemployment, and multiple destructive outcomes, including health and crime disparities, as well as problem substance use. Finally, I conclude that sociological researchers must engage with broader publics and diverse coalitions if they are to contribute to an alternative social policy—a holistic, regional "disaster response"—that takes multiple layers of causality into account, and addresses the core of vulnerabilities that make such disasters possible.     

Relationship between productivity, quality and musculoskeletal disorder risk among deboning workers in a Chilean salmon industry

The purpose of this ergonomic investigation is to establish a relationship between quality, productivity and risk of musculoskeletal disorder (MSD) in manual bone-removal process in the salmon fish industry. The method consists in a follow up study of 14 workers in a lane that processes salmon steak. Time between each steak (work cycle), quality of the steak's meat through inspection of deepness and length of the gapping generated by the manual bone-removal process and risk for musculoskeletal disorders through OCRA method were considered for this study. IMC and musculoskeletal Nordic Questionnaire of Kourinka were applied to the workers evaluated. Fourteen women worker's completed the evaluation, age 37.67 ± 8.1, with 65.27 ± 34.41 months of experience, with an IMC of 27.18 ± 3.87 (1.52 ± 0.057 meters of height) at the time of the evaluation. Time for deboning per steak averaged 38 ± 14 seconds with 68.33 ± 14.79 steaks per hour per worker. In quality terms, 74% of the steaks were qualified as "premium steaks" and 26% as "grade or industrial" (lower category and cheapest price). OCRA index for the right hand average 13.79 ± 4.59 and 3.59 ± 0.41 for the left hand. From Nordic questionnaire 80% of the workers manifested musculoskeletal symptoms in the right hand/wrist, followed up by shoulder with 60% of the workers and arm/elbow with over 50%. There was no statistically significant relationship between productivity and quality of the steak after manual bone removal process and between quality and MSD risk. However, there was a statistically significant relationship between productivity and MSD risk (p<0.05). Discussion around the results allows to see complementary results that did have strong correlation between MSD risk and the presence of lower grade salmon steaks and between areas that present musculoskeletal symptoms (MSS) and the intensity of the MSS (p<0.05). The results showed that further research is needed to validate these relationships, due to the increasing demands of health-care services from this productive sector, considering its importance for this region.     

Sexual Orientation as a Factor in Career Development

As I reviewed the available case information on Allan, the concept of career development shaped my impressions of the client. “Career development is, for most people, a lifelong process of getting ready to choose, choosing, and typically, continuing to make choices from among the many occupations available in our society. Each person undertaking this process is influenced by a great number of factors, including family, personal values and aptitudes, and societal context” (Brown, Brooks, & Associates, 1990, p. xvii). As this statement suggests, career development is a holistic approach to counseling individuals. Each “factor” represents a piece of the puzzle that guides the individual through the process. Life-style issues (i.e., family, leisure, sexual orientation, personal values, societal context), as well as interests, work values, and skills are tightly interwoven within an individual's major or career choice.     

Parent loss and childhood bereavement: some theoretical considerations

This paper attempts to review critically the major psychoanalytic positions on the impact of parent loss during childhood. An effort is made to review systematically the issues of the loss of a parent as a love object, the loss of a parent as a narcissistic injury, children's cognitive understanding of death, and the relationship between loss and trauma. Two questions are raised by our efforts to understand the impact of the loss of a parent through death on children under ten years of age. First, what psychological tasks do children confront and what modes of coping do they use to deal with such an event? And, second, does such an event invariably lead to some pathological result for the child, or may its effects be normalized in the course of time? Although these questions may be seen as empirical questions needing to be answered through the collection of data that would confirm or negate the hypotheses generated, the questions are always posed within the context of a theoretical framework that colors how data is collected and which data is collected. By reviewing the theoretical positions, we come to the conclusion that no single approach is sufficient to explain the complexity of the impact of the death of a parent on a child. We propose that since no integrated conceptual framework presently encompasses all that needs to be explained, it is necessary to use a multivariant approach. Such an approach may be helpful in generating hypotheses and in beginning the task of systematic data collection.     

Teaching research in practice courses

Students of social work and related professions are often resistant to study research. Efforts to resolve this problem have focused on making research courses more experiential and developing a 'user friendly' curricula. This article presents an experimental strategy used in one American school of social work to teach research-related content within the context of a practice course. Students' and teachers' evaluations indicate that this may be useful to enable students to acquire tools with which to use and conduct research.     

The moderating effects of culture on peer deviance and alcohol use among high-risk African-American Adolescents

African-American adolescents have lower rates of alcohol consumption than White youth. However, African-American youth suffer disproportionately more adverse social, mental, and physical health outcomes related to alcohol use. Affiliating with negative peers is a risk factor for alcohol initiation and consumption. Cultural variables have shown moderating effects against other risk factors for African-American youth and therefore were the focus of this study. Specifically, we tested whether three culturally-relevant variables, Africentric beliefs, religiosity, and ethnic identity were promotive or protective for alcohol initiation and use within the context of negative peer affiliations. The sample consisted of 114 at-risk African-American adolescents whose ages ranged from 13 to 20. Participants were administered a questionnaire with measures of alcohol initiation and use, peer risk behaviors, ethnic identity, Africentric beliefs, religiosity, and demographic items. Peer risk behaviors accounted for significant percentages of the variance in age of alcohol initiation, lifetime use, and current and heavy alcohol use after adjusting for age and gender. Cultural variables showed both promotive and protective effects. Africentric beliefs were promotive of delayed alcohol initiation, whereas both Africentrism and religiosity moderated peer risk behaviors effect on alcohol initiation. Africentric beliefs were also inversely related to lifetime alcohol use revealing a promotive effect. Moreover, there were significant protective effects of ethnic identity and religiosity on heavy alcohol consumption. One implication of these findings is that prevention programs that infuse cultural values and practices such as Africentrism, ethnic identity, and religiosity may delay alcohol initiation and reduce use especially for youth with high risk peers.     

Towards improved measurement of cognitive and behavioural work demands

Determination of the cognitive and behavioural demands of work is an important part of holistic workplace intervention. Attention to these factors is especially important when developing return-to-work programs for persons with reduced cognitive, behavioural or psycho-emotional capacity, and when designing risk management programs in organizations. Occupational therapists have the background knowledge and skills to assess these components of work, but often lack valid and reliable measurement tools. This paper reports on three field studies that assessed the reliability and validity of ratings made by novice users of the City of Toronto Job Demands Analysis, which includes a measure of cognitive and behavioural work demands. Numerous challenges to accuracy and reliability that are common to empirical measurement were disclosed, including the necessity for clear and strong definitions, and the importance of thorough rater training. Implications for therapist training and mentorship are discussed.