Screening of risk from patient manual handling with MAPO method

International standards highlight the steps required by risk assessment and involving first hazard identification, then risk evaluation and finally, if necessary, risk assessment. To check approach appropriateness to "risk evaluation" from manual patient handling through MAPO, a cross study was carried out in view of checking relationship between this new risk assessment model and occurrence of acute low back pain. After proper training the MAPO screening method was assessed in 31 wards, 411 exposed subjects of geriatric hospitals. At the same time health data were collected on occurrence of low back pain episodes during the last year both in the exposed subjects' group and the external reference group (n?237). Risk and clinical assessment data were tutored and checked by EPM research unit. The logistic analysis was used as a method to evaluate the relationship between risk index and acute low back pain. Investigating relationship between acute low back pain episodes and levels of MAPO screening index, carried out only with the people exposed who claimed to work for at least 30 hours per week (n = 178), showed definitely positive trends. The study results indicate that MAPO screening may represent a useful tool to estimate the risk from manual handling patients.     

An ergonomic approach to improve work conditions of older employees in social housing

French companies are legally required to develop action plans to improve employment and work conditions for older workers ("plans seniors"). These plans contain measures oriented towards recruiting, career evolution, skills developme1nt, knowledge transmission and improvement of work conditions. A tool for assessing work situations experienced by council buildings caretakers ("gardiens") was used in such a plan on behalf of the main agency of council housing in Paris, and we developed. This assessment tool was developed after ergonomic work analysis on a sample of 36 older caretakers (age > 57 y.o). The technical inspectors in charge of technical interventions on buildings and managing caretakers were trained to use the assessment tool and apply it to all caretakers aged 50 and over.     

Designing the safety of healthcare. Participation of ergonomics to the design of cooperative systems in radiotherapy

This communication deals with the involvement of ergonomists in a research-action design process of a software platform in radiotherapy. The goal of the design project is to enhance patient safety by designing a workflow software that supports cooperation between professionals producing treatment in radiotherapy. The general framework of our approach is the ergonomics management of a design process, which is based in activity analysis and grounded in participatory design. Two fields are concerned by the present action: a design environment which is a participatory design process that involves software designers, caregivers as future users and ergonomists; and a reference real work setting in radiotherapy. Observations, semi-structured interviews and participatory workshops allow the characterization of activity in radiotherapy dealing with uses of cooperative tools, sources of variability and non-ruled strategies to manage the variability of the situations. This production of knowledge about work searches to enhance the articulation between technocentric and anthropocentric approaches, and helps in clarifying design requirements. An issue of this research-action is to develop a framework to define the parameters of the workflow tool, and the conditions of its deployment.     

Interviewing children versus tossing coins: accurately assessing the diagnosticity of children's disclosures of abuse

We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of children's disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children's reactions to the alleged abuse.     

Reliability of professional judgments in forensic child sexual abuse evaluations: unsettled or unsettling science?

In the absence of photographic or DNA evidence, a credible eyewitness, or perpetrator confession, forensic evaluators in cases of alleged child sexual abuse must rely on psychosocial or "soft" evidence, often requiring substantial professional judgment for case determination. This article offers a three-part rebuttal to Herman's (2009 ) argument that forensic decisions based on psychosocial evidence are fundamentally unreliable and that this conclusion represents settled science. The article also discusses the potentially adverse consequences of Herman's proposed reforms to forensic practice on child protection and prosecution efforts.     

Treatment of premenstrual syndrome: a decision-making algorithm

The aim of this short paper will be to guide the clinician through the plethora of possible interventions to help them to individualize treatment for their patients with PMS. The discussion will highlight management principles rather than evidence per se. It uses as its basis an updated version of the treatment algorithm published by the RCOG in its Green Top Guideline no. 48 on the management of PMS.     

Exercise self-regulation among older women participating in a heart disease-management intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.     

政府旅游开发方式评析——以土耳其为例

提起旅游,人们脑海里首先浮现的必然是"阳光与海滩"。土耳其是地中海地区的一个主要国家,在历史、文化、自然风光、美食、民俗等方面都具有巨大潜力,并且土耳其人民也非常热情友善。土耳其拥有21世纪的游客所寻求的异国风情。为使土耳其的这种潜力在继续服务于旅游业的同时保持其延续性,就需要认真的自省与科学的研究和规划。旅游业对于一国的社会福利和经济发展有着举足轻重的影响,但也存在毁灭当地资源的可能。理性运用旅游资产、增加游客数量和提高旅游收入,这些都可以通过有效的旅游规划来实现。在此问题上,中央政府、地方政府和非政府组织在相互协作的框架下各司其职显得至关重要。本文通过揭示当前土耳其旅游业的现状,对中央和地方政府扮演的角色做出评析,希望从国家管理的风格和方式角度出发,使土耳其的旅游规划和政策取得实际效果。     

新奥尔良的发展:一部环境灾难史

2005年,卡特里娜和丽塔两大飓风侵袭路易斯安那州的新奥尔良市,成为美国历史上造成损失最大的灾难之一。这一貌似自然灾害的危害事件,其实孕育于新奥尔良的长期发展之中。一部新奥尔良发展史,既是人类利用土地、河流、森林、海洋等自然实体并与自然环境搏斗以建立城市、发展航运和工商业的历史,也是这些自然实体及其哺育的众多生命不断受侵蚀以至戕害的历史。这既是一部人类文明史,也是一部环境灾难史。在这里,人类借助水利工程控制自然而建立起来的文明,由于损害了生态系统的健康,削弱了其自然防护能力,结果反而加剧了人类无法避免的自然灾害的危害。因此,飓风造成的损失不只是取决于风暴之力,也取决于人们对土地的所作所为。而保持新奥尔良生机的努力,并不需要一味地与自然相搏,与自然合作,也是一种有益的尝试。