Job stress management protocol using a merge between cognitive-behavioral techniques and ergonomic tools

This paper presents a protocol for work distress assessment. Work distress is defined as a merge between nonergonomic related aspects, in tasks or environment, and adversely conditions perceived for a worker, in a certain work situation. This frame requires an approach that can treat individuals and organizational factors in the same way, at the same time. For this, we elaborate a psycho-ergonomics method, associating concepts and practices from cognitive-behavioral techniques and work ergonomic analysis, which we named CEWAT - Cognitive-Behavioral Work Analysis Technique. This paper presents CEWAT's foundations and structure, in steps. An application to a complex and dangerous system illustrates its benefits in the ergonomics action.     

Resolving complex community problems: Applying collective leadership and Kotter's change model to wicked problems within social system networks

How does collective leadership within social networks resolve chronic and complex problems common to communities? Unfortunately, sometimes it does not, but when it does, the outcome may be truly extraordinary. We use a case study approach to explain how one Midwest community within the USA applied collective leadership within a community network to reduce teen births. It took ten years of what many identified as provocative media campaigns and comprehensive sex education programs to reduce teen births by 65%, significantly exceeding the stated goal. Using Kotter's change model as a backdrop, powerful strategies and provocative creativity reveal courageous leadership within a social network of diverse people and organizations focused on improving the social well being of their community.     

Higher Education's Role in the Dialogue on Race

The university is a logical locus for discussionof the role race has played in our society. Perhaps noAmerican institution is more committed to free andopen dialogue than the university. Higher educationcan thus provide a context for the recognition ofissues as well as a forum for the resolution ofinitiatives. To date, however, university attempts atdiversity training have often imbued recipients withself-consciousness, usurping the unity implicit in theword `university' and evoking an even greater tendencytoward separatism. The university's traditional questfor truth has been subverted by a subtle and pervasivesense that some views are more correct than others,that openness is dangerous, and that some issues mighteven be taboo. At best, such an approach to diversityleads to a fragile stalemate among self-containedenclaves. By championing President Clinton's call fora dialogue on race, the university can restore itselfas an institution that puts honesty above all else.Not only is there a resonant rationale for theuniversity's central responsibility in this debate,but there is also a pedagogical means by which itsrole can be realized. This paper proposes a model forethnic dialogue relevant to either a text-based orissues-based class. Borrowing from pedagogy developedin professional schools, we believe that the tenets ofthe `case method' can create a climate conducive tothe substantive scrutiny of race, ethnicity, andprejudice in general. We argue that this dialogueshould not be a mere add-on to college life, butintegrated into existing curricula in the socialsciences, literature, and history. Heated debate canthen occur without anger, and race/ethnicity can bediscussed without fear of recrimination.Paradoxically, the very expression of ethnicity may bethe catalyst that eventually moves multiculturalismtoward interculturalism – where differences are nolonger articulated, measurable or even discernible.     

Risk Estimation and Value-of-Information Analysis for Three Proposed Genetic Screening Programs for Chronic Beryllium Disease Prevention

Genetic differences (polymorphisms) among members of a population are thought to influence susceptibility to various environmental exposures. In practice, however, this information is rarely incorporated into quantitative risk assessment and risk management. We describe an analytic framework for predicting the risk reduction and value-of-information (VOI) resulting from specific risk management applications of genetic biomarkers, and we apply the framework to the example of occupational chronic beryllium disease (CBD), an immune-mediated pulmonary granulomatous disease. One described Human Leukocyte Antigen gene variant, HLA-DP beta 1*0201, contains a substitution of glutamate for lysine at position 69 that appears to have high sensitivity (approximately 94%) but low specificity (approximately 70%) with respect to CBD among individuals occupationally exposed to respirable beryllium. The expected postintervention CBD prevalence rates for using the genetic variant (1) as a required job placement screen, (2) as a medical screen for semiannual in place of annual lymphocyte proliferation testing, or (3) as a voluntary job placement screen are 0.08%, 0.8%, and 0.6%, respectively, in a hypothetical cohort with 1% baseline CBD prevalence. VOI analysis is used to examine the reduction in total social cost, calculated as the net value of disease reduction and financial expenditures, expected for proposed CBD intervention programs based on the genetic susceptibility test. For the example cohort, the expected net VOI per beryllium worker for genetically based testing and intervention is $13,000, $1,800, and $5,100, respectively, based on a health valuation of $1.45 million per CBD case avoided. VOI results for alternative CBD evaluations are also presented. Despite large parameter uncertainty, probabilistic analysis predicts generally positive utility for each of the three evaluated programs when avoidance of a CBD case is valued at $1 million or higher. Although the utility of a proposed risk management program may be evaluated solely in terms of risk reduction and financial costs, decisions about genetic testing and program implementation must also consider serious social, legal, and ethical factors.     

Who Holds the Stakes? A Case Study of Stakeholder Identification at Two Nuclear Weapons Production Sites

Traditional risk assessments, including those involving the United States Department of Energy (USDOE), are often criticized for producing useless or noncredible management responses because they did not meaningfully involve the public. The first step to involve the public is to identify appropriate active participants (stakeholders). This study was done to understand the processes used to identify stakeholders to serve on advisory boards established at the two largest remediation sites in the United States: the Hanford Nuclear Reservation in Washington state and the Savannah River Site in South Carolina. The Hanford stakeholder identification process produced an interest-based board whereas the Savannah River Site strategy produced population-based representation. The basic goals of the stakeholder advisory groups were similar. However, different processes were used to identify the participants for the groups in part because of distinctly different social and cultural conditions in the areas affected by the operations of the two facilities, and in part because of the different level of trust of the USDOE and their contractors at Hanford compared with Savannah River. The discussion analyzes their different needs and potential for successful citizen participation.     

FIRST AND SECOND MARITAL DISSOLUTION: A DECOMPOSITION EXERCISE FOR WHITES AND BLACKS

Observed distributions of marital dissolutions occurring over time (and thus the divorce rate or other measures of marital dissolution) are dependent on two basic factors: (1) the relative distribution across a population of characteristics influencing the probability of marital dissolution and (2) the relative degree to which each of these characteristics raise or lower the probability of marital dissolution. The purpose of this article is to examine the impact of each of these two factors on the observed distributions of marital dissolution for whites and blacks for both first and second marriages. Using an appropriate statistical methodology, the results indicate a relatively complex pattern of differences between marriage orders and race groups.     

In sickness but not in health: self-ratings, identity, and mortality

Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study (NHEFS) data for respondents with circulatory system disease (N = 3,709) and respondents with no diagnosable disorders (N = 1,127) at baseline, we test the idea that individuals with experience of chronic disease of the circulatory system will have more predictive self-ratings of health than healthy individuals. Poor or fair self-rated health increased the adjusted hazard of all-cause mortality for respondents with circulatory system disease, but not for respondents who were healthy. Additional analyses confirm that poor or fair self-rated health is particularly predictive for respondents with self-reported history of circulatory system diagnoses and perception of symptoms, but not for respondents without symptoms or diagnoses prior to the NHANES physical exam.     

Evaluation of two school-based HIV prevention interventions in the border city of Tijuana, Mexico

This research project examined the individual and combined effectiveness of an HIV prevention workshop and a free condom distribution program in four high schools in Tijuana, Mexico. Adolescents (N = 320) completed baseline measures on sexual practices and theoretical correlates and participated in a two-part study. In Study 1, students were randomly assigned to an HIV prevention workshop or a control condition, with a 3-month follow-up assessment. Results indicate three significant workshop benefits regarding HIV transmission by altering sexual initiation, access to condoms, and traditional beliefs regarding condoms. In Study 2, we set up a condom distribution program at two of the participating schools, and students completed a 6-month follow-up assessment. Results indicate that exposure to the workshop followed by access to the condom distribution program yielded two beneficial results for reducing HIV transmission: moderating sexual initiation and increasing condom acquisition. Access to the condom distribution program alone had no effects on behavioral and psychosocial correlates of HIV transmission. We discuss implications of these results.