Examination of computer task exposures in radiologists: a work systems approach

Radiologists are intensive computer users as they review and interpret radiological examinations using the Picture Archiving and Communication Systems (PACS). Since their computer tasks require the prolonged use of pointing devices, a high prevalence of Musculoskeletal Disorders (MSDs) is reported. The first phase of this study involved conducting a Cognitive Work Analysis in conjunction with a Participatory Ergonomics approach to perform a total work system analysis. We also conducted an ergonomic survey as well as collected computer use data, specifically for the mouse and keyboard. The goal of the study was to reduce the physical exposures for radiologists. This paper presents Phase I results describing the analyses and redesign process of the radiologists tasks, training design, computer use, and selected survey results.     

Can't Buy My Love: A Typology of Female Sex Workers' Commercial Relationships in the Mexico–U.S. Border Region

Female sex workers (FSWs) experience elevated risk for HIV and sexually transmitted infections (STIs) through unprotected sex with male clients, yet the complexity of these commercial relationships remains understudied. From 2010 to 2011, we explored FSWs' conceptualizations of various client types and related risk behavior patterns using semistructured interviews with 46 FSWs in Tijuana and Ciudad Juarez, Mexico, where FSWs' HIV/STI prevalence is increasing. Our grounded theory analysis identified four types of commercial relationships: nonregular clients, regular clients and friends, clients who “fell in love” with FSWs, and long-term financial providers who often originated from the United States. As commercial relationships developed, clients' social and emotional connections to FSWs increased, rendering condom negotiation and maintaining professional boundaries more difficult. Drug abuse and poverty also influenced behaviors, particularly in Ciudad Juárez, where lucrative U.S. clients were increasingly scarce. While struggling to cultivate dependable relationships in a setting marked by historical sex tourism from a wealthier country, some FSWs ceased negotiating condom use. We discuss the need for HIV/STI research and prevention interventions to recognize the complexity within FSWs' commercial relationships and how behaviors (e.g., condom use) evolve as relationships develop through processes that are influenced by local sociopolitical contexts and binational income inequality.     

The Marital Attitudes Scale: Assessing and Treating Ambivalent Clients

This article explores the complexities of the couple relationship commonly observed in the clinical settings of couple therapists. Whether described as the “push–pull” of the couple dyad, the mixed agenda couple, the couple that is leaning out versus leaning in, or the ambivalent couple, the literature suggests that this dynamic is to be assessed and explored before fully engaging in relational therapy or pursuing separation or divorce. The Marital Attitudes Scale is a 48-item self-report inventory that was normed with a clinical and nonclinical population at 2 clinical training sites. The inventory adheres to a cognitive-behavioral theoretical orientation with 4 subscales and a total score that measure cognitions, emotions, behaviors, schemas, and total scores relative to the ambivalence or the absence of commitment in the couple relationship. The instrument uses the frame of preambivalent, or committed to the relationship; ambivalent, ambivalently committed to the relationship; or postambivalent, no longer committed to the couple relationship. The inventory has evidenced good validity and reliability and is considered to be a useful inventory for assessing the degree of commitment to the relationship when a couple engages in therapy. This article explores the development of the inventory, its cognitive-behavioral theoretical orientation, the literature around the theme of marital dissolution, the concept of relational ambivalence, and the interface between assessment and therapeutic engagement.     

Effects of a participatory ergonomics intervention computer workshop for university students: a pilot intervention to prevent disability in tomorrow's workers

A participatory approach was used to create a computer ergonomics workshop for college students, incorporating an instructional systems design process and adult learning inquiry perspectives. The primary objective of this participatory ergonomic pilot intervention was to involve students throughout the training design process in solving computer workstation ergonomic problems and adopting healthy computing behaviors. Students' level of participation included becoming part of the training design team, a co-facilitator, or a student trainee. A second objective was to examine the translation of an industrial office ergonomics training program into a college computer ergonomics training program. The long term goal was to reduce upper extremity symptoms and disability. The program was piloted at one private university. The three student trainees significantly increased their knowledge of computer ergonomics from 69% of test items answered correctly pre-training to 82% post-training. Trainees were also successful in conducting computer ergonomic evaluations of students' computing work areas. They achieved 100% accuracy in identifying ergonomic problems and proposing solutions in five ergonomic workstation assessments in the field. This approach was successful in creating a sense of ownership among the student developers and facilitators as reflected in their self-reports during a post-intervention debriefing. The results of this pilot study justify formal controlled trials of this intervention in university students, who will become tomorrow's workers.     

Strangers in a Strange Land: Shock,Disappointment, and Adjustments Experiences of Expatriates in Central Asia

Increasing globalization is driving an increase in diversity and interaction. A more mobile and international workforce frequently requires that individuals try to understand the norms of their “new” society. This paper provides a preliminary exploration of the types of issues and concerns raised by expatriates working in a new foreign environment. In particular, the paper uses a hybrid survey/interview methodology to identify specific issues raised by expatriates working in Kazakhstan, Central Asia.

Assessing safety at the end of clinical trials using system organ classes: A case and comparative study

Recent approaches to the statistical analysis of adverse event (AE) data in clinical trials have proposed the use of groupings of related AEs, such as by system organ class (SOC). These methods have opened up the possibility of scanning large numbers of AEs while controlling for multiple comparisons, making the comparative performance of the different methods in terms of AE detection and error rates of interest to investigators. We apply two Bayesian models and two procedures for controlling the false discovery rate (FDR), which use groupings of AEs, to real clinical trial safety data. We find that while the Bayesian models are appropriate for the full data set, the error controlling methods only give similar results to the Bayesian methods when low incidence AEs are removed. A simulation study is used to compare the relative performances of the methods. We investigate the differences between the methods over full trial data sets, and over data sets with low incidence AEs and SOCs removed. We find that while the removal of low incidence AEs increases the power of the error controlling procedures, the estimated power of the Bayesian methods remains relatively constant over all data sizes. Automatic removal of low-incidence AEs however does have an effect on the error rates of all the methods, and a clinically guided approach to their removal is needed. Overall we found that the Bayesian approaches are particularly useful for scanning the large amounts of AE data gathered.     

Individualized functional work evaluation and vision: a case study in reasonable accommodation

A case study is provided where functional capacity evaluation, work place assessment, and driver rehabilitation assessments were combined to produce an individualized functional work evaluation. A human rights complaint was launched by worker who alleged that her employer had determined that her vision impairment rendered her incapable of meeting her job demands, which could not be 'reasonably accommodated'. An evidence based practice approach and clinical reasoning process utilized by the assessor in developing an individualized evaluation is described. The individualized evaluation developed by the assessor is consistent with the clinical trend towards the inclusion of direct observation of actual occupational performance, in making a determination of work ability. The resulting individualized evaluation was integral to the Human Rights Tribunal in determining whether the worker's limitations could be "reasonably accommodated.'