Work accommodation for people with multiple chemical sensitivity

Multiple chemical sensitivity (MCS) is a term used to describe allergic-like reactions to chemicals that represent everyday exposures in industrialized countries. It is sometimes associated with electromagnetic sensitivity, and both conditions are most likely engendered by environmental exposures. Prevalence studies suggest that chemical sensitivity affects 12-15% of the US population and that it crosses age, socio-economic status and racial lines. Electromagnetic sensitivity is less understood, but affects a portion of those with chemical sensitivity. Persons with these environmental sensitivities often experience difficulties with health care, housing and work. Workplace barriers result in significant disability, with ensuing financial loss and isolation for the worker. We examined work accommodations for 100 persons with self-reported MCS and its relation to life satisfaction. Results are discussed in terms of accommodating invisible disabilities that challenge industrial capitalism.     

Estimating urban lawn cover in space and time: Case studies in three Swedish cities

Lawns are considered monocultures and lesser contributors to sustainability than diverse nature but are still a dominating green area feature and an important cultural phenomenon in cities. Lawns have esthetical values, provide playground, are potential habitat for species, contribute to carbon sequestration and water infiltration, but also increase pesticides, fertilization, are monocultures and costly to manage at the same time. To evaluate the potential impact of lawns, whether positive or negative, it is of interest to estimate the total lawn cover in cities and its change over time. This is not a straightforward process, e.g., because many lawns are small and covered by trees. In this study we review the existing literature of lawn cover in cities and the different methodologies used for cover estimation. We found both pros and cons with NDVI and LiDAR data as well as manually interpreted aerial photos. The total cover of lawns in three case study cities was estimated to 22.5%. By extrapolating these percentages to all Swedish cities lawn cover was estimated to 2589 km² (0.6% of the terrestrial surface). The approximated total municipal management cost of lawns in all Swedish cities was 910,000,000 USD/ year. During 50 years lawn area almost doubled in relative cover and 56% of them were continuously managed. Since lawns constitute large parts of the urban greenery and are costly to manage it is highly relevant to consider their social, ecological and cultural value compared to alternatives, e.g., meadows with less intensive management.     

Suicide and mental health problems among Swedish youth in the wake of the 1990s recession

The purpose of this explorative study is to bring together a variety of Swedish data sources with indicators of youth mental health and living conditions in order to illuminate trends during the last decades, elucidate possible determinants of mental ill health and develop hypotheses to explain the observed trend patterns. The analyses in the study reveal some surprising inconsistencies with respect to the mental health trends among young people during the 1990s. Most striking is the pattern of increasing youth unemployment coinciding with almost inverse trends in the rates of suicide. The secular trends in fatal suicides during this period do not show any increase but some actual decrease in sub‐populations despite high sustained levels of unemployment. In contrast, survey data indicate that the general mental health of youth during this period appears to have deteriorated.     

Age limits for participation in child protection court proceedings in Sweden

According to the UN Convention on the Rights of the Child and Swedish legislation, children have the right to participate in child protection proceedings. The aim of this paper is to describe and analyse the notion of age and maturity in child protection proceedings in order to elucidate how these aspects could influence children's rights to participate. We focus on the view of three groups of actors involved in child protection proceedings in Sweden—social workers, lawyers, and laypersons in social welfare boards and administrative courts—and on how children's age and maturity should be taken into consideration in decisions on their participation in court. The analysis is based on survey data. The study found that social workers, laypersons, and lawyers have different views on when children are old enough to have the right to litigate in court. Additionally, there is no consensus on how the maturity of the child can be assessed to inform the decision about participation. More discussion is needed about what competences a child needs to participate in court and to what extent this right should be limited by their age. Importantly, courts and decision‐making proceedings can be made more child friendly.     

Building a culture of learning through organizational development: the experiences of the Marin County Health and Human Services Department

After determining a need for organizational change informed by changes in workforce demographics, community demographics, the socio-political and economic environment, and constraints on resources, one agency sought to transform its organizational culture into that of a learning organization. An external organizational development consultant was hired to work with agency leadership to identify ways that would help move the agency's culture towards one that was conducive to learning. Specifically, the agency director sought to create a culture where communication is encouraged both vertically and horizontally, frontline level workers are engaged and their voices heard, cross-departmental problem solving is practiced, innovative ideas are supported, and evidence-informed practice regularly implemented. This case study describes the experiences of this agency and the process taken toward engaging an external consultant and moving towards the development of a culture of learning.     

Importance of active listening in treating workers with musculoskeletal disorders

Female assembly workers reporting constant neck and shoulder pain, despite ergonomically acceptable working conditions, were interviewed. As a starting point in the interviews, the patients were asked to describe their general situation at work. Their reports were fed back and discussed with company management in a wider group meeting and resulted in an improvement in their attitudes to those workers. A climate of confidence and well-being was created, which the women experienced as genuine. The workers' report of pains improved dramatically and absence due to musculoskeletal disorders was reduced by more than 90% during the following year.     

Health care applications of complexity science. Life at the edge of chaos

The authors explore complexity science, a relatively new field of inquiry, which holds for both clinicians and health care leaders the real possibility of stimulating fresh insights and approaches to health and medical care-both its provision and its organization. Two case studies are presented to illustrate how complexity theory can provide health care leaders with a new perspective on how to address the myriad challenges they confront daily: (1) a patient with dissociative identity disorder; and (2) a physician task group charged to advise on hospital medical staff reorganization and governance. These case studies help clinicians and leaders of health care organizations understand how complexity: (1) may be relevant, even helpful, as they consider difficult challenges in both patient and organizational management; and (2) might emerge as a synthesizing force as they face the extraordinarily complicated task of jointly creating integrated health care systems. A resource section is provided for those who may wish to further pursue the topic.