The economic evaluation of a Participatory Ergonomics programme to prevent low back and neck pain

This study was an economic evaluation conducted alongside a cluster randomised controlled trial with a follow-up of 12 months. The aim was to evaluate the cost-effectiveness and cost-benefit of the Stay@Work Participatory Ergonomics programme (PE) compared to a control group (no PE). In total, 37 departments (n=3047 workers) were randomised into either the intervention (PE) or control group (no PE). During a meeting, working groups followed the steps of PE, and composed and prioritized ergonomic measures aimed to prevent low back pain (LBP) and neck pain (NP). Working groups had to implement the ergonomic measures within three months in their department. Cost data included those directly related to LBP and NP. Cost-effectiveness analyses (CEA) and cost-benefit analyses (CBA) were performed. After 12 months, health care costs and costs of productivity losses were higher in the intervention group than in the control group (the mean total cost difference was $/euro$127; 95% CI $/euro$-164 - $/euro$418). From a societal perspective, the CEA showed that PE was not cost-effective compared to control for LBP and NP prevalence, work performance, and sick leave. The CBA from a company perspective showed a monetary loss of $/euro$78 per worker. The PE programme was neither cost-effective nor cost-beneficial on any of the effect measures.     

Depression screening,education, and treatment at the workplace: A pilot study utilizing the CDC Health Scorecard

Depression is a significant health issue for many Americans, ranking among the top worksite issues resulting in referrals to Employee Assistance Programs (EAPs) with prevalence rates in the working population of more than 6%. This study was part of a larger statewide assessment conducted using the Centers for Disease Control and Prevention (CDC) Worksite Health Scorecard. The purpose of this study is to examine the number of Kentucky workplaces currently offering screening, education, and treatment related to depression. The study also aims to compare the number of Kentucky workplaces offering these elements by size and industry type. The one-time, cross-sectional assessment surveyed a random sample of 1,200 worksites to examine worksite offerings of screening, education, counseling, management training, and health insurance coverage related to depression. Results showed that the majority of worksites do not provide employee depression screening, education and counseling, management training on identifying warning signs of depression, or comprehensive treatment and follow-up for employees with depression. Smaller worksites (<250 employees) were even less likely than larger companies to provide screening, education, counseling, training, and insurance coverage for depression. Increasing the provision of these wellness components at the worksite has potential to improve the quality of life for employees and reduce the financial burden to employers.     

Broadening opportunities for job seekers with disabilities: strategies to effectively provide assistive technology in One-Stop centers

The Workforce Investment Act (WIA) of 1998 mandates that partners in the One-Stop Career Center (One-Stop) system be prepared to serve a diverse customer base, including job seekers with disabilities. For many such individuals, effective service delivery depends in part on the existence of appropriate and efficient assistive technology (AT) options. This article presents challenges experienced by One-Stop partners related to AT provision as well as strategies for providing effective AT support. Findings from case study research conducted in several One-Stops across the country revealed three strategies that have enhanced employment services and addressed barriers. These are (a) an accurate assessment of AT needs, (b) staff training and practice using the equipment, and (c) the ability to make the most of limited financial resources. Implications for the most efficient ways to provide AT options are discussed.     

Participation in higher education for students with disabilities: an Irish perspective

Third level institutions have been encouraged to facilitate greater access and participation for people from marginalized groups who have traditionally been excluded from higher education. In Ireland, as elsewhere, people with disabilities have been included in this process. Few studies have explored the quality of access and participation for students with disabilities within higher education, and this small scale qualitative study aimed to explore this issue. Students with disabilities reported variable access experiences within higher education and physical access remains a serious obstacle to full participation. Generally, there was a low level of awareness of student needs in relation to assistive provision and assessment. A positive and informed staff/college attitude proved crucial in ensuring access and equitable treatment. This research highlights the inherent limitations in the current piecemeal institutional response to provision for students with disabilities. A comprehensive access service is required that addresses the needs of all marginalized groups and becomes an integral part of the third level institution.     

The effects of a workplace intervention on employees’ cortisol awakening response

Work-related stressors are known to adversely affect employees’ stress physiology, including the cortisol awakening response (CAR) – or the spike in cortisol levels shortly after people wake up that aids in mobilizing energy. A flat or blunted CAR has been linked to chronic stress and burnout. This daily diary study tested the effects of a workplace intervention on employed parents’ CAR. Specifically, we tested whether the effects of the intervention on CAR were moderated by the type of days (workday versus non-work day). Data came from 94 employed parents from an information technology firm who participated in the baseline and 12-month diurnal cortisol components of the Work, Family, and Health Study, a group-randomized field experiment. The workplace intervention was designed to reduce work-family conflict (WFC) and implemented after the baseline data collection. Diurnal salivary cortisol was collected on 4 days at both baseline and 12 months. Multilevel modeling revealed that the intervention significantly increased employees’ CAR at 12 months on non-workdays, but this was not evident on workdays or for employees in the usual practice condition. The results provide evidence that the intervention was effective in enhancing employees’ biological stress physiology particularly during opportunities for recovery that are more likely to occur on non-work days.     

Implementation and evaluation of an HIV/STD intervention in Peru

This paper presents the lessons learned through a process evaluation (PE) after 1 year of implementation of a 2-year community intervention in Lima, Peru. The intervention consisted of training and motivating community popular opinion leaders (CPOLs) for three marginal population segments to disseminate prevention messages among their peers. PE data included: observations, qualitative interviews with CPOLS, conversations and messages delivered by CPOLs, training facilitators' perceptions about implementation, and a survey of CPOLs. The PE helped to document and enhance the intervention. CPOLs were motivated to talk to their peers. CPOLs perceived that their participation had an effect on their own risk behaviors and saw their role as beneficial to their community. The PE was helpful in examining training delivery and the feasibility and acceptability of the intervention in order to assess the elements related to program success necessary to replicate the CPOL model.     

Effects of early support intervention on workplace ergonomics--a two-year followup study

The purpose of the controlled longitudinal study was to determine the effect of a tailored early support intervention method on workers' workplace ergonomics. The main areas of the early support intervention were training, guidance and support for supervisors in finding weak signals of impaired ergonomics. Supervisors were also trained to bring up these weak signals in discussion with employees and to make necessary changes at the workplace. The data consisted of 301 intervention subjects and 235 control subjects working in the field of commerce. The questionnaires were carried out in 2008 and in 2010, and the response rates among both groups were 45%. We used multivariate repeated measures analysis of variance (MANOVA) to test the difference in the groups at two points of time. The main result was that in the areas of work environment, the interaction between group and time was statistically significant (p=0.0004). The work environment improved in the intervention group, but deteriorated in the control. Working methods improved due to the interventions, but physical load factors increased over time in both groups. According to the study, tailored early support intervention has a generally beneficial impact on workers' workplace ergonomics in the areas of work methods, work environment and accident factors.     

Speech recognition software as an assistive device: a pilot study of user satisfaction and psychosocial impact

The purpose of this study was to gather data concerning the psychosocial (quality of life) impact of speech recognition software on individuals with physical disabilities and to identify how satisfied these individuals were with this software as a computer access method. Two standardized questionnaires, the Psychosocial Impact of Assistive Devices Scale (PIADS) and the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) were administered to ten participants with physical disabilities who received speech recognition software following an assistive technology evaluation. The results of this study indicated that 90% of the participants were quite satisfied with speech recognition software as an assistive device and that the software had a somewhat positive psychosocial impact on their lives. Four themes emerged concerning what the participants liked most about the software: 1) the software provided a method of access when they were not previously accessing a computer, 2) the software increased independence, 3) the software made computer use more efficient, and 4) the software provided a choice or flexibility in computer access. Although this study demonstrated that these speech recognition software users are generally satisfied with the software and it has had a positive impact on their life, it also suggests that there is a need to examine the role of training on satisfaction and successful use of the software.     

The Utility of Personality Inventories in the Employee Assistance Process

Abstract

A study was conducted to assess the usefulness of objective measures of personality in (a) the identification of employees in need of an employee assistance program (EAP) and (b) the evaluation of employee mental health change as a result of EAP participation. In addition, comparisons of EAP referred and non-referred employees were made on race, sex, age, and performance variables. MMPI, CPI, and SRA-Verbal Form test data from all or part of a sample of 376 police officers referred for fitness-for-duty evaluations were used in various analyses. Many of the officers were reassessed following an EAP intervention, while others chose not to accept the intervention (forming a natural control group). It was found that the MMPI-2 has the potential utility in both the identification and evaluation stages of the EAP process. Males and black employees were found to more likely to be referees to an EAP. Finally, it was found that referred employee performance was more than a half a standard deviation lower than that of non-referred employees.     

Efficacy of newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia: a systematic review

We conducted a systematic review to evaluate the efficacy and adverse effects of newer drugs used to treat lower urinary tract symptoms (LUTS). The drugs were either Food and Drug Administration (FDA) approved for benign prostatic hyperplasia (BPH) or not FDA approved for BPH but have been evaluated for treatment of BPH since 2008. We searched bibliographic databases through September 2017. We included randomized controlled trials (RCTs) lasting one month or longer published in English. Outcomes of interest were LUTS assessed by validated measures. Efficacy was interpreted using established thresholds indicating clinical significance that identified the minimal detectable difference. Twenty-three unique, generally short-term, RCTs evaluating over 9000 participants were identified. Alpha-blocker silodosin and phosphodiesterase type 5 inhibitor tadalafil were more effective than placebo in improving LUTS (moderate strength evidence) but these drugs had more adverse effects, including abnormal ejaculation (silodosin). Anticholinergics were only effective versus placebo when combined with an alpha-blocker. Evidence was generally low strength or insufficient for other drugs. Evidence was insufficient to assess long-term efficacy, prevention of symptom progression, need for surgical intervention, or long-term adverse effects. Longer trials are needed to assess the effect of these therapies on response rates using established minimal detectable difference thresholds, disease progression, and harms.     

Introvision in der Arbeitsvermittlung für Fallmanager und Arbeitslose

In the context of a pilot study the effects of the educational-psychological intervention Introvision were tested with older long-term unemployed people. The project was accomplished in the time by 1.4.2010 to 31.12.2010 in co-operation between ARGE Paderborn and the research group Introvision. In the context of the project 16 employees of ARGE Paderborn participated in an advanced training to Introvision, 31 customers of ARGE Paderborn began a coaching to get introduction in Introvision and 20 have also finished. Nine customers decided to participate five individual coachings. The results show, that the offers have a high individual use for the participants. To the central changes belong improved handling of stress, decrease of social isolation, improved (self-) perception as well as a higher self-confidence and a more open co-operation between customers and employees of ARGE Paderborn. Besides four participation began a job on the first labour market and two could be connected to a honorary activity.     

Process evaluation of an environmental walking and healthy eating pilot in small rural worksites

Small Steps are Easier Together (SS) was a pilot environmental intervention in small rural worksites in Upstate New York in collaboration with Extension educators. Worksite leaders teamed with co-workers to select and implement environmental changes to increase walking steps over individual baseline and to choose healthy eating options over 10 weeks. Participants were 226 primarily white, women employees in 5 sites. A mixed methods process evaluation, conducted to identify determinants of intervention effectiveness and to explain differences in outcomes across worksites, included surveys, self-reports of walking and eating, interviews, focus groups, and an intervention log. The evaluation assessed reach, characteristics of recruited participants, dose delivered, dose received, and context and compared sites on walking and eating outcomes. Emergent elements of participant-reported dose received included: active leadership, visible environmental changes, critical mass of participants, public display of accomplishments, accountability to co-workers, and group decision making. Participants at sites with high reach and dose were significantly more likely than sites with low reach and dose to achieve intervention goals. Although this small pilot needs replication, these findings describe how these evaluation methods can be applied and analyzed in an environmental intervention and provide information on trends in the data.     

PAY SECRECY AND EFFORT PROVISION

Pay secrecy is often justified on the ground of concerns about the detrimental consequences of intra‐firm pay comparisons for work morale and performance. Surprisingly, however, there is only limited empirical evidence that the availability of pay comparison information is detrimental for effort provision. In this paper, I study pay comparison effects in a gift‐exchange game laboratory experiment where an employer is matched with two symmetric employees. I compare effort choices made by employees in a “pay secrecy” treatment and in two “public wages” treatments where employees are informed of the wage paid to the co‐worker. In one “public wages” treatment the employer can choose both wages she pays to the employees, while in the other treatment the wage paid to one employee is regulated exogenously. I show that pay disclosure can be detrimental for effort provision if employees are treated unequally. (JEL A13, C92, J31)     

Training effects on motor–cognitive dual-task performance in older adults

This systematic review investigated whether healthy older adults benefit from training interventions in motor–cognitive dual-task (DT) situations and which specific aspects of the intervention and/or task selection contribute to training benefits. Training effects were analysed with regard to the training programme (e.g., general ST or DT training) and task conditions (e.g., standing or walking, complexity of secondary cognitive task). Literature was searched via OVIDsp (Medline, EMBASE, PsycINFO). DT studies were included by the following criteria: (1) investigation of at least one motor task, (2) assessment of DT performance outcomes on standing or walking, (3) conduction of an intervention, and (4) investigation of older adults in an experimental–control group design or an old–young comparison. Thirteen studies met all inclusion criteria. Four types of interventions were identified: (1) general single-task (ST) motor training, (2) specific ST motor training, (3) general DT training, and (4) task-related (specific) DT training. For DT standing conditions only DT interventions improved motor performance, whereas DT walking also benefits by ST training. Most benefits on motor and cognitive performance seem to be reached by DT training interventions whereas a GST produced lowest effects. Thus, balance orientated motor and cognitive DT performance in healthy older adults can be improved by performance related exercises. Furthermore, to reach beneficial effects, it seems necessary that the training intervention includes a certain level of exercise load such as rising difficulties, appropriate intensity and duration, a certain level of task specificity, and variable task prioritization. The transfer of training effects into everyday situations needs to be further investigated.     

Explaining feast or famine in randomized field trials. Medical science and criminology compared

A feast of randomized controlled trials (RCTs) in medical science and comparative famine in criminology can be explained in terms of cultural and structural factors. Of central importance is the context in which the evaluation of interventions is done and the difference in status of situational research in the two disciplines. Evaluation of medical interventions has traditionally been led by practitioner (clinical) academics. This is not the case in criminal justice, where theory has had higher status than intervention research. Medical science has advanced in, or closely associated with, university teaching hospitals, but links between criminology and criminal justice services are far more tenuous. The late development of situational crime prevention seems extraordinary from a medical perspective, as does the absence of university police schools in the United Kingdom and elsewhere. These structural and cultural factors explain concentration of expectation, resource, and RCT productivity in medical science. The Campbell Collaboration and the Academy of Experimental Criminology are forces which are reducing this polarization of feast and famine in RCTs. But unless scientific criminology is embedded in university schools which are responsible for the education and training of law, probation, and police practitioners, convergence in terms of RCTs and implementation of findings in practice seems unlikely.     

Enhancing the quality of life of a client with severe developmental disabilities through the application of assistive technology. A case study

This paper describes a structural sequential process aimed to enhance the quality of life of a 29 year old man through the application of assistive technology (AT). The client had life-long severe multiple disabilities, showed increasing fragility and decreasing functional abilities that resulted, among other problems, in a problem with toileting. The process involved a thorough assessment and evaluation of the client, his physical, cognitive and perceptual skills involved in the performance of the task, requirements of the task, the technology, and the task environment. A clinical reasoning model for the provision of AT was applied during the process to identify the functional deficits of the client with respect to the problematic task. The approach enabled a multidisciplinary team of university-affiliated professionals including physical and occupational therapists, an ergonomist, a rehabilitation engineer and care providers in an institution for developmentally disabled people to determine the primary attributes of a technological intervention. The process resulted in the selection of an appropriate piece of AT followed by its modification and adaptation in order to address the specific needs of the client. The client's toilet use was improved in a manner that ultimately contributed to enhancing the quality of his life. Projections for further improvements of the quality of life of the client in this institution were also discussed.     

Ergonomics in a hospital and a university setting: The effect of worksite analysis on upper extremity work-related musculoskeletal disorders

OBJECTIVES: The purpose of this study was to determine whether individuals with work-related injuries receiving worksite analysis would have less lost workdays than individuals not receiving worksite analysis. Therapeutic management of work-related injuries in a hospital and a university setting were also compared. STUDY DESIGN: Over a one-year period, employees who sustained an upper extremity work-related injury were issued questionnaires regarding their injury, treatment, functional status and pain level. Participants were divided into three groups: group 1 consisted of hospital employees (N=14) who underwent worksite analysis, group 2 included university employees (N=15) who underwent worksite analysis whereas group~3 included university employees (N=14) who underwent no analysis. RESULTS: All groups were similar in demographics, functional status, and pain level. Satisfaction with the worksite analysis was similar for groups one and two. CONCLUSION: A pattern of less absenteeism but greater modified duty days was associated with those individuals undergoing worksite analysis.     

Attracting Micro‐Enterprises To Learning

Micro‐enterprises, i.e. firms with less than 10 employees, are traditionally the hardest to engage in learning; they are also least likely to participate in such measures as business advice and guidance provision and initiatives to support information communication technology (ICT) adoption. Through a community‐based initiative initially targeting parents (unemployed or employed) to participate in ICT, 30 micro‐enterprises were attracted to learning for the first time. These companies had carefully avoided similar initiatives taking place locally, which emphasized business success and growth; they had only participated in this ICT skills training because of their children. The paper takes a case study approach to evaluate the reasons for participation, explores barriers and implications for those organizing similar activities, and calls for a more holistic view of owners and managers of small firms as fathers, mothers, etc. rather than just as ‘entrepreneurs’.     

Efficacy of a Facial Emotion Training Program for Children and Adolescents with Autism Spectrum Disorders

Twenty-five high-functioning, verbal children and adolescents with autism spectrum disorders (ASD; age range 8–15 years) who demonstrated a facial emotion recognition deficit were block randomized to an active intervention (n = 12) or waitlist control (n = 13) group. The intervention was a modification of a commercially-available, computerized, dynamic facial emotion training tool, the MiX by Humintell©. Modifications were introduced to address the special learning needs of individuals with ASD and to address limitations in current emotion recognition programs. Modifications included: coach-assistance, a combination of didactic instruction for seven basic emotions, scaffold instruction which included repeated practice with increased presentation speeds, guided attention to relevant facial cues, and imitation of expressions. Training occurred twice each week for 45–60 min across an average of six sessions. Outcome measures were administered prior to and immediately after treatment, as well as after a delay period of 4–6 weeks. Outcome measures included (a) direct assessment of facial emotion recognition, (b) emotion self-expression, and (c) generalization through emotion awareness in videos and stories, use of emotion words, and self-, parent-, and teacher-report on social functioning questionnaires. The facial emotion training program enabled children and adolescents with ASD to more accurately and quickly identify feelings in facial expressions with stimuli from both the training tool and generalization measures and demonstrate improved self-expression of facial emotion.