Potential strategies to avoid progestogen-induced premenstrual disorders

Non-hormonal approaches to premenstrual syndrome (PMS) treatment such as selective serotonin reuptake inhibitors are by no means effective for all women and frequently we must resort to endocrine therapy. During many of the hormonal approaches, PMS-like symptoms can be introduced or re-introduced during the necessary cyclical or continuous progestogen component of the therapy. This is seen with combined oral contraception, progestogen only contraception, progestogen therapy for heavy menstrual bleeding and endometriosis, sequential hormone replacement therapy and any therapeutic strategy for premenstrual syndrome where it is necessary to provide endometrial protection, including estrogen suppression of ovulation or add-back during gonadotrophin releasing hormone suppression. The link to progestogen is very often missed by health professionals. When the pattern of symptoms mimics the cyclicity of PMS, it is termed progestogen-induced premenstrual disorder. The need to use progestogen to protect the endometrium from the proliferative actions of estrogen can pose insurmountable difficulties in managing premenstrual disorders. In the absence of any really useful evidence, nearly all practice in this area depends on clinician experience. We cannot afford to wait for adequate research evidence to be produced - it never will - and so we must rely on empirical findings, clinical experience, theoretical strategies and common sense.     

Slope effect on pushing forces

In some occupations pushing forces are frequent when performed on horizontal ground and are standardized (ISO 2002). In special cases employees are obliged to grow container on slopes and the strains are poorly investigated. The objective of this work is to measure forces required to push garbage container on horizontal and inclined at 0, 4, 11 and 16 % grounds. Sudden and significant increases in heart rate reflect the possible risk of heart overload in long displacements. This study proposes realistic limits and provides a simple and protective tool for a group of employees without distinction of age or gender. These limits can even be reduced to a quasi-linear model where push 200 kg is the maximum for 0% slope and 60 kg for 10% slope.     

Assessments of patients with a 5-category or a 3-category practical classification system: validaty and practicality

In order to implement preventive programs to prevent back pain in nurses, assessments of the degree of passivity and mobility of patients is imperative. After all, the load in health care ergonomics, is often the patient. The degree of cooperation or resistance determines the load on the back for the nurses and the necessity of the use of lifting devices like patient lifters or sliding sheets. These assessments must be done in both a practical and a reliable way. For this purpose a 3-category and a 5- category system to assess the degree of patient mobility and passivity was developed and tested. The results are presented on the poster.     

Flying through the hospital: efficiency and safety of an ergonomic solution

In hospitals many horizontal transfers (from stretcher to bed etc.) are performed from the moment a patient is admitted (f.e. with an ambulance) through examination departments all the way to the wards. These transfers can be very strenuous and solutions may be to use a special lifting device that accompanies the patient on this route: a stretcher sling This is a specially designed disposable lifting sling for horizontal transfers and repositioning, the sling can easily be connected to a ceiling or mobile lift. The ambulance service, two hospitals and a manufacturer decided to study the effects. The stretcher sling travels with the patient. Does this provide an ergonomically sound solution and is this an effective and efficient solution? The results were positive, but a behavioral change was also necessary.     

The effect of visualization method on the performance of simulated microsurgery tasks

The operating microscopes may be a significant cause of fatigue and discomfort in surgeons. The need for the microscope to be placed over the operating field forces surgeons to remain at the microscope's eyepieces at an uncomfortable posture for the entirety of the surgery. This study compared the effects on microsurgical task performance for four visualization methods: a monocular microscope, a binocular microscope, a three-dimensional (3D) flat-panel television display and a two-dimensional (2D) flat-panel television display. Eleven subjects each performed two microsurgical tasks and their performance was documented by video camera. The statistical analysis performed indicated utilization of the microscope as a visualization method increased subject performance. No significant difference in performance between the 2D and stereoscopic visualization methods.     

Interface of drug use

Packaging and labeling play a crucial role awhile protecting medicaments and transmitting a range of crucial information to the users. Taking into account the scarcity of specific studies in this area, it was considered great the need for a comprehensive survey about customers' satisfaction when handling these containers.     

Social firms: Sustainable employment for people with mental illness

Objective: Social firms or enterprises aim to offer sustainable employment in supportive workplaces for people who are disadvantaged in the labour market. Therefore, this study sought to explore employees' views in one social firm about the features of their workplace that they found supportive.Participants: Seven employees were recruited, all of whom experienced persistent mental illness, and had worked in this social firm for between eleven months and six years. Methods: A semi-structured interview, the Work Environment Impact Scale (version 2.0), was used to explore participants' views of their workplace and to rate how its physical and social characteristics impacted them. Participants also rated their job satisfaction with a modified Indiana Job Satisfaction Scale. Results: Features of the social firm workplace identified by these employees as contributing to their sustained employment and satisfaction were the rewards, task demands, work schedule, and workplace interactions with supervisors and other co-workers. From their views, guiding principles for the development of supportive workplaces and evaluation of their capacity to afford sustainable employment were derived. Conclusions: This study adds to current knowledge about workplace supports from an employee perspective, and is of relevance for informing future social firm development, workplace design and evaluation.     

Social firms: Building cross-sectoral partnerships to create employment opportunity and supportive workplaces for people with mental illness

A major barrier to employment for people with mental illness is limited access to supportive and non-discriminatory workplaces. Social firms are businesses committed to employing up to 50% of people with a disability or other disadvantage and to providing supportive work environments that benefit workers. Little research has been conducted to understand the features and social processes that support the vocational experiences of employees with mental health issues in social firms. Objective: This ethnographic study sought to explore the experiences of nine employees at one Australian social firm. Participants: Nine employees of a social firm, with and without mental illness. Methods: Study methods used included participant observation, interviewing and document analysis. Results and conclusions: The study highlights the complexity of running a socially-invested business, and the importance of cross-sectoral partnerships to support their operational success. Natural workplace supports, adequate training and support infrastructure and enabling participation in the business, were identified as important to creating a supportive workplace. Partnerships within the workplace and in support of the workplace are discussed. Future growth and development of partnerships are recommended to support the establishment of social firms.     

The Problem with Self-Forgiveness: Forgiving the Self Deters Readiness to Change Among Gamblers

Self-forgiveness is generally understood to be a mechanism that restores and improves the self. In the current study, we examine the possible deleterious consequences of forgiving the self among gamblers-specifically in regard to gamblers' readiness to change their problematic behavior. At a large Canadian university, 110 young adult gamblers' level of gambling pathology was assessed, along with their readiness to change and self-forgiveness for their gambling. Participants were 33 females and 75 males (2 unspecified) with a mean age of 20.33. Results revealed that level of pathology (at risk vs. problem gamblers) significantly predicted increased readiness to change. Self-forgiveness mediated this relationship, such that level of gambling pathology increased readiness to change to the extent that participants were relatively unforgiving of their gambling. Implications for seeking professional assistance as well as treatment and recovery are discussed.