Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators

Typing is associated with musculoskeletal complaints (MSCs), caused by multiple risk factors. Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC's, only few of them were found evidence based. This study aimed to test the efficacy of a workplace intervention in reducing MSC's among computer workers. 66 computer workers were assigned randomly to one of three intervention programs: ergonomic intervention including biofeedback, intervention without biofeedback and control group without intervention. The efficacy was tested by advanced assessment including; pain location and severity, posture at work, upper extremity 3D kinematics, muscle activity and psychosocial status. Working hypothesis; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures: pain complaints, upper extremity kinematics, muscle activity and psychosocial status. Significant differences were found between pre and post intervention and between research groups and the control group in pain, posture and motion. The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions. In conclusion; the proposed intervention program was found efficient for reducing pain among computer workers.     

Psychosocial Profile of Children Having Participated in an Intervention Program for Their Sexual Behavior Problems: The Predictor Role of Maltreatment

This study sought to verify if a history of maltreatment may predict the psychosocial profile of children who participated in an intervention program aiming at reducing sexual behavior problems. Data were collected at both the beginning and the end of the intervention program using a clinical protocol and standardized tests selected on the basis of the intervention targets. In general, the results indicate that children who had experienced maltreatment display a psychosocial profile that is similar to that of children who had not experienced maltreatment. However, children who had experienced psychological abuse or neglect may display greater externalized or sexualized behaviors, whereas children who have a parent who had been a victim of sexual abuse may display fewer sexualized behaviors.     

Systemic Consultation in Intellectual Disability Case Management

Systemic consultation is a form of tertiary case supervision derived from the principles of systemic family therapy. The present study defines the process and outcomes of systemic consultation through the experiences of case managers (CMs) working with people who have an intellectual disability. CMs were invited to present and discuss one of their complex cases with a team of consultants and attend a follow up session 4 to 6 weeks later. Measures of levels of stress, perception of workplace functioning, and workflow information were completed pre and post‐intervention and compared to measures completed by a second group of CMs receiving regular supervision only. After participation in systemic consultation, the networks of people CMs consulted about the case were significantly smaller and they scored significantly higher on a network measure of efficiency of information flow. The CMs experienced lower levels of stress and higher perception of workplace functioning, these differences approached significance. After attending the consultation outcome, themes included a reduced sense of being stuck and stressed, becoming an agent of change and taking perspective. The approach allows CMs space for reflection on practice and new perspectives to be heard. Case management has been under‐represented in documented research and evidence‐based training and supervision models, and is an area in which professional theory appears to be lacking.     

Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.     

Effects of early support intervention on workplace ergonomics--a two-year followup study

The purpose of the controlled longitudinal study was to determine the effect of a tailored early support intervention method on workers' workplace ergonomics. The main areas of the early support intervention were training, guidance and support for supervisors in finding weak signals of impaired ergonomics. Supervisors were also trained to bring up these weak signals in discussion with employees and to make necessary changes at the workplace. The data consisted of 301 intervention subjects and 235 control subjects working in the field of commerce. The questionnaires were carried out in 2008 and in 2010, and the response rates among both groups were 45%. We used multivariate repeated measures analysis of variance (MANOVA) to test the difference in the groups at two points of time. The main result was that in the areas of work environment, the interaction between group and time was statistically significant (p=0.0004). The work environment improved in the intervention group, but deteriorated in the control. Working methods improved due to the interventions, but physical load factors increased over time in both groups. According to the study, tailored early support intervention has a generally beneficial impact on workers' workplace ergonomics in the areas of work methods, work environment and accident factors.     

Finding Meaningful Support: Young People's Experiences of “Risky” Environments

This paper reports on the qualitative phase of a New Zealand study of young people who had been exposed to “risky” environments from a young age. These young people had experienced traumatic events such as abuse, violence, addictions, mental health issues, and many had been excluded from school. The young people (aged between 13 and 17) were users of multiple services (statutory and nongovernmental services including: child welfare, juvenile justice, remedial education, and mental health services). Qualitative interviews (n?=?109) explored young people's experiences in their families, communities, education, and their perspectives on support provided by services and their own support networks. Three thematic clusters emerged as central motifs in young people's experiences and are the focus of this article: navigating “risky” environments; services and support; and, working to find different pathways.     

Constituents of healthy workplaces

The aim of the study presented here was to identify and characterize the constituents of a healthy workplace from the viewpoints of employees at four different companies with low rate of absenteeism due to illness. A non-randomized, purposive selection was made of 27 respondents -- four department heads, 16 white-collar workers, and seven blue-collar employees. The respondents were told to describe in writing how they experience factors contributing to good health at their workplace. The data analysis was carried out with a phenomenographic approach. Four main categories of health-related factors emerged: Good Work Environment, Active Keep-Fit Measures, Functional Leadership and Individual Responsibility. The employers fulfil demands for a good physical working environment, but the need for improvements in the psychosocial environment remains. The most promising finding is that the respondents' accept personal responsibility for maintaining their own good health.     

The impact of high-calorie-expenditure exercise on quality of life in older adults with coronary heart disease

The acceptability of a high-calorie-expenditure (HCE) exercise program in older coronary heart disease patients participating in a behavioral weight-control program was evaluated. Seventy-four overweight patients (median age 63 yr) were randomly assigned to a 5-mo intervention of HCE exercise (3,000-3,500 kcal/wk daily walking) or standard cardiac-rehabilitation (CR) exercise (700-800 kcal/wk). Both groups received counseling to achieve a dietary caloric deficit of 3,500 kcal/ wk. Assessments at baseline and 5 mo included self-reported measures of quality of life and psychosocial variables. The HCE group experienced significantly greater weight loss (8.2 ± 4 vs. 3.7 ± 5 kg, p < .001). Changes from baseline to 5 mo on scores of physical, emotional, and social functioning were greater for the HCE than CR group (p < .05). HCE exercise also resulted in greater positive change in exercise enjoyment (p = .05), which was mediated by weight change. Even high-risk older adults can be successful in an HCE exercise program and experience no adverse physical or emotional changes.     

Psychosocial factors related to job stress and women in management

This literature review explores women in management and how the psychosocial factors they face in the workplace affect their job-related stress level. The psychosocial factors identified include tokenism, sexual harassment and discrimination, work-family conflict, and workload. Various studies are cited and solutions to decrease job-related stress level are included.     

Raising awareness of psychosocial factors in the occurrence of low back symptoms in developing countries

Although there is strong evidence that single physical, psychosocial and organisational risk factors are each independent predictors of low back symptoms (LBS), little is known about their combination/interaction, particularly in those working in developing countries. A total of 1294 Indonesian coal mining industry workers reported information about physical, psychosocial, and organisational factors using self-reported questionnaires and were placed into one of four combination exposure groups: 1) high physical (working with bent trunk; whole body vibration exposure; lifting) and high psychosocial (high effort; low reward; work stress), 2) high physical and low psychosocial, 3) low physical and high psychosocial, and 4) low physical and low psychosocial (as the reference group). The odds of LBS in the high physical and high psychosocial group was 5.15 times (95% confidence interval 2.69-9.86) that of the reference group. Psychosocial factors played a more important role than physical factors in increasing the likelihood of reporting LBS. Permanent and night shift workers were more likely to report LBS. These findings imply that efforts to reduce LBS in this workplace should address both psychosocial and physical factors but psychosocial factors should be the priority, with a special focus on permanent and night shift workers.     

Effect of a workplace design and training intervention on individual performance, group effectiveness and collaboration: the role of environmental control

The effects of a workplace design and training intervention and the relationships between perceived satisfaction of office workplace design factors (layout and storage) and work performance measures (individual performance, group collaboration and effectiveness) were studied with 120 office workers using the Workplace Environment Questionnaire. Further, we examined whether environmental control had a direct effect on work performance, and then explored whether environmental control mediated or moderated the relationship between workplace design factors and work performance. Results showed a significant, positive impact of the intervention on environmental satisfaction for workstation layout. Satisfaction with workstation layout had a significant relationship with individual performance, group collaboration and effectiveness; and satisfaction with workstation storage had a significant relationship with individual performance and group collaboration. Environmental control had a direct impact on individual performance and group collaboration; whereas, the mediating and moderating effects of environmental control on the relationship between workplace design factors and outcome variables were not significant.     

Interaction between employees' physical load factors and early support at the workplace

Physical workload is a continuous problem, even in modern workplaces. The purpose of the survey was to determine the effect of support on employees' physical load factors at workplaces. Training, guidance and support were the main focus areas of the early support intervention, which aimed to enable supervisors to find weak signals of impaired ergonomics.The survey was carried out in the form of a controlled longitudinal study, and the material was gathered via a questionnaire in both 2008 and 2010 from two co-operative trade groups. The final sample was 301 intervention subjects and 235 control subjects, and the response rate was 45% in both groups. We applied factor analysis to reduce the number of items. The physical load factors' sum score consisted of six items. We used logistic regression in the statistical analysis.Encouragement to improve processes at the workplace increased the probability of positive change (i.e. decrease) in physical load factors. The same applied to working pace, if individuals could control it themselves. In contrast, workload and the support of supervisors had a reversed impact on workers' physical load factors. Focusing on promoting workers' ergonomics is still important in workplaces when aiming to decrease physical load factors.     

Launching the workplace flexibility movement: work family research and a program of social change

The Alfred P. Sloan Foundation's Workplace, Work Force & Working Families program was established in 1994 and ended in 2011. Over the course of its 17-year lifespan, this program – through its vision, commitment and unique, pragmatic grant-making strategies – pioneered the interdisciplinary field of work–family research and spearheaded a national movement to create more flexible workplaces that effectively meet the needs of employees and employers. The program's first strategic phase supported high-quality, multidisciplinary research to examine what was happening within working families at all stages of their lives, both at home and at work. Results from these investigations highlighted the structural mismatch between the needs of this diverse workforce – comprised increasingly of working parents and older workers – and the demands of a rigidly structured workplace requiring full-time, full-year work, with little to no flexibility in how, when, or where work gets done. After a decade of scholarly research documenting that the challenges facing American families were not private, individual problems but public, societal concerns, the Sloan Foundation designed and launched in 2003 the National Workplace Flexibility Initiative. Its goals were twofold: to make workplace flexibility a compelling national issue and to establish it as a standard of the American workplace. As a result of the collective efforts of Sloan-supported organizations and people, the stage is now set for a social movement to realign the structure of the American workplace to the needs of the twenty-first century workforce. Lessons for subsequent research-driven social movements close the article.     

Training for Abusive Caregivers:

This article proposes a model for elder abuse intervention based on a recently implemented caregiver training program. Caregivers at-risk for abuse were offered traiing through mental health centers on biopsychocosil issues in aging, problem-solving, stress and anger management, and utilization of community resources. Participants were compared with similar caregivers on measures of psychosocial well-being to examine the efficacy of training. Participants experienced some reduction in symptoms of psychological distress and caregiving burden over time while symptoms worsened or remained unchanged for non-participants. Suggestions are made for utilizing this approach in cases of founded abuse.     

Evaluating the effectiveness of ergonomics application

The effectiveness of ergonomics application is achieved in the course of this research by reviewing ergonomics literature, Internet searches and case studies of a number of work related musculoskeletal disorders (WMSD's) and other ergonomic related workplace incidence rate. The results of ergonomic intervention control measures such as engineering controls, administrative controls and personnel protective equipment were also studied. The findings in this paper may help to development model for analysing and solving ergonomic problems in the workplace. It concludes on the need for management to support ergonomics intervention programme for effective cost saving, litigation avoidance and better productivity.     

ADHD in juvenile offenders: treatment issues nurses need to know

1. When working with juvenile offenders with ADHD, advanced practice nurses should consider prescribing stimulant medication in conjunction with other psychosocial interventions to achieve maximum treatment success. 2. Nurses working with young people with ADHD in the justice system must carefully coordinate care among all health care providers and juvenile justice personnel, including attorneys, probation/parole officers, and court assessment personnel. 3. Advocating for the individual needs of clients and their families is critical; often, this includes advocating for care that is not only evidence based, but also culturally competent.     

Can Early Intervention Have an Impact on Future Life? A Study of Life Events,Social Interaction,and Child Behavior Among Mothers at Psychosocial Risk and Their Children Eight Years After Interaction Treatment

Forty-six mothers at psychosocial risk who had undergone interaction treatment when their children were babies were studied with respect to experienced negative life events, social network, and behavior problems in children. One reference group comprising 45 nontreated mothers at psychosocial risk and one comprising 56 mothers without psychosocial problems was used. Children in the study group had experienced more life events than the children of nonrisk mothers but fewer than the children of untreated psychosocial risk mothers. They had a poorer social network than nonrisk mothers, and the children had fewer acting-out behavior than the children of nontreated risk mothers.     

The employment situation of people with disabilities in Lebanon: challenges and opportunities

This article presents the findings of a study on the employment situation of people with disabilities in a rural region in Lebanon. The study was conducted as one of the activities of a community development project that saw the establishment of a job centre for people with disabilities. The majority of the study's 200 paricipants were unemployed, and many had never been employed. Other participants were mostly self-employed, with many of them working from home. The article discusses obstacles to finding and keeping a job and ends with recommendations for change at the level of community intervention, policy and research.     

Family Roles as Moderators of the Relationship Between Schedule Flexibility and Stress

Employer initiatives that address the spillover of work strain onto family life include flexible work schedules. This study explored the mediating role of negative work–family spillover in the relationship between schedule flexibility and employee stress and the moderating roles of gender, family workload, and single‐parent status. Data were drawn from the 2008 National Study of the Changing Workforce, a nationally representative sample of working adults (N = 2,769). The results indicated that schedule flexibility was associated with less employee stress and that these associations were mediated by perceptions of negative work–family spillover. This study found the moderating relationships of gender, family workload, and single parenting in the relationships between schedule flexibility and negative work–family spillover and stress. Schedule flexibility had stronger relationships in reducing negative work–family spillover and stress among women, single parents, and employees with heavier family workloads. The findings provide empirical support for intervention efforts involving schedule flexibility to reduce workplace stress among employees with family responsibilities.