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Results for “harmful working position”

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PubMed1997

[A combined methodology for understanding the duration of breast feeding the poor neighborhoods of Managua, Nicaragua].

This study examined the relationship of several maternal variables to the duration of exclusive breast-feeding and the total duration of breast-feeding, along with attitudes, perceptions, and beliefs about breast-feeding among women living in poor neighborhoods of Managua, Nicaragua. The field work was carried out in December 1992 and January 1993 using qualitative and quantitative methods. A structured questionnaire was administered in interviews with 556 mothers of children under 12 months of age, and meetings of four directed discussion groups were held, in which a total of 20 women participated. At one week of age, almost all the children of the mothers who were surveyed had been breast-fed, but only 45% had been exclusively breast-fed. At 12 weeks old, 30% were already completely weaned. The discussion groups revealed the coexistence of positive opinions about both breast-feeding and bottle-feeding. However, exclusive breast-feeding was considered harmful for the mother, and breast milk was not thought to be sufficient nourishment for the child. Previous experience was strongly related to the duration of exclusive breast-feeding and to total breast-feeding duration. Attitudes, social support, and work situation were important factors influencing the total length of time women breast-fed a child. In general, the results obtained through the interviews and in the discussion groups were in agreement and showed that the elements needed to promote exclusive breast-feeding were social support, a favorable community environment, and policies that dealt with problems faced by working mothers. The complementary research methods were useful for obtaining information about the relative importance of different factors that determine the duration of breast-feeding and for understanding that practice in greater depth from the mother's point of view.

Adolescent↗
PubMed1992

Two key factors that belong in a macroergonomic analysis of electronic monitoring: Employee perceptions of fairness and the climate of organizational trust or distrust.

Two microergonomic elements not usually discussed in treatments of electronic monitoring of VDT clerical work are employee perceptions of fairness (in work standards and measurement process) and the overall climate of employee trust in management. The author's field studies found these factors serving as major mitigating or intensifying elements in the stress that clerical employees can experience when they perform intensive heavy-duty VDT applications, and as central variables in distinguishing beneficial from harmful monitoring programmes. A case study involving change in supervisory monitoring policies for 200 customer service agents at one of Federal Express Corporation's telecommunication call centres in the USA in 1985-86 demonstrates how a Unit Head at a non-union company long known for its positive employee relations policies installed monitoring practices that the call agents considered unfair and a breach of the company's traditional climate of employee-employer trust. Employee protests, when communicated to top management, led to discarding the unilaterally-instituted and quantity-oriented monitoring policy and replacing it with a consensually-developed supervisory monitoring system balancing quality and quantity elements in a way that satisfied both employees and management. The present system of supervisory monitoring of customer service work at Federal Express (1991) enjoys broad employee support, suggesting that a fair system of monitoring, applied in an environment of earned trust between employees and employer, can meet critical productivity and quality interests of employers in clerical VDT work without creating harmful employee stress and discontent. It also suggests that empirical investigation of the fairness and trust factors represents an important and practical area of research in a macroergonomic analysis of employee monitoring programs and impacts.

Journal Article↗
PubMed2001

Prevalence of hepatitis C among injection drug users in England and Wales: is harm reduction working?

OBJECTIVES: This study sought to establish the prevalence of hepatitis C antibodies (anti-HCV) and hepatitis B antibodies (anti-HBc) among injection drug users in England and Wales. METHODS: A voluntary cross-sectional survey collected oral fluid samples and behavioral information; 2203 injectors were recruited through drug agencies, and 758 were recruited in the community. RESULTS: Prevalence was 30% for anti-HCV, 21% for anti-HBc, and 0.9% for HIV antibodies. Anti-HCV prevalence rates were significantly greater among those with longer injecting careers, those in older age groups, those residing in London, those recruited in drug agencies, those positive for anti-HBc, and those with a previous voluntary HIV test. CONCLUSIONS: Anti-HCV prevalence rates among injectors in England and Wales, where comprehensive harm reduction programs exist, are lower than rates in other industrialized countries.

Adult↗
PubMed2005

Interfacing clinical practice and error prevention.

Medication error is a major source of preventable harm to patients in hospitals and is an area in which, it is suggested, information technology will have a positive impact. This paper presents findings from part of a study that examined current information utilisation patterns during nursing medication rounds. Nursing working patterns in medication administration are poorly understood despite being one of the most likely sources of medication error. Methods used were drawn from principles of Human Computer Interaction (HCI), using a semi-structured observational tool for analysing system requirements and data elements. Results from this study indicated that clinical and contextual factors impact on nursing patterns of information handling in many ways, including documentation quality, location of information sources and current patterns of computer utilization. Numerous extraneous interruptions also impact on the ability of nurses to assimilate and use clinical information effectively. These results were used to develop a conceptual framework for interfacing error prevention in clinical practice. These insights into the human factors that are the reality of clinical practice allow us to design and develop effective information technology systems to help prevent nursing medication administration errors.

Humans↗
PubMed1998

[Lights and shadows on the molecular diagnosis of hepatitis C].

The rational application of molecular biology to clinical diagnostics must take in consideration the economic demands, as the waste of sophisticated and expensive assays is of no use for the physician prescribing the assays and burdensome for the individual or the community paying them. Sometimes it is useless to apply to the molecular biology, and the information obtainable through serology answer our demands. This brief survey of the principal means available today for Hepatitis C diagnosis and monitoring, besides summarising the principles on which the different techniques are based, wants to underline the most noteworthy aspects of the different assays--from general indication to specific application to a single case--in the attempt to improve the efficacy of the test, which may be the right one at the right moment. There are qualitative and quantitative methods for viremia determination, which not always are alternative; on the contrary they must sometimes be complementary in order to obtain a complete clinical pattern. As a matter of fact the clinician should choose according to protocol susceptibility and considering what the expected viremia could be. The risk of false negatives is very dreadful for the clinician, as that of false positives (from contamination) is threatening for the laboratory, which must carry out more work than its capabilities consent. One must not misuse these diagnostic means, but they must be used correctly in order not to transform an important service into a harmful inefficiency with unpleasant consequences both for the physician and the patient.

DNA Probes↗
PubMedDate not supplied

Assessment of significant harm: improving professional practice.

Judging whether a child is suffering or is likely to suffer 'significant harm' has become a critical task for professionals working in the field of child health. Yet little guidance is available about what the phrase means in its entirety or how it should be applied in practice. This study set out to clarify the position by examining how the phrase was used in practice by a selected sample of experienced health and social work staff. The evidence collected suggests flaws in the general approach adopted by professionals to identification and assessment in child protection cases. The data indicate a heavy concentration of attention on the weaknesses of families being assessed rather than their strengths and on parents rather than children. Problems are identified in responding effectively to long-term, chronic abuse such as emotional abuse and neglect.

Child↗
PubMedDate not supplied

[The social hygiene problems in the operator work of hydroelectric power station workers and the means for enhancing work capacity].

Weight, tension and harmfulness of professional activity, peculiarities of labour conditions and characteristics of work, shift dynamics of operative personnel's working capacity were studied in the course of 8-hour working day currently accepted at hydroelectric power stations (HEPS) and experimental 12-hour schedule. Working conditions classified as "admissible", positive dynamics of operators' state, their social and material contentment were a basis for 12-hour two-shift schedule to be recommended as more appropriate. At the same time, problem of optimal shift schedules for operative personnel of HEPS remains unsolved and needs to be further explored.

Adult↗
PubMed1977

Subjects' rights, freedom of inquiry, and the future of research in the addictions.

Since the recent passage of regulations concerning subjects' rights and freedom on inquiry, opposition by the public and others to some areas of research in the addictions has prevented its implementation or continuation. Research investigators in the biomedical and behavioral sciences have been placed in the position of defending their work in an adversary climate. The author points out the importance of transmitting to the public, the scientific community, and legislators the investigators' concern that "subjects' rights" not be viewed only in a legalistic context, but also in the context of not harming the patient.

Advisory Committees↗
PubMed2002

Rationalization of shape and related stress distribution in posterior teeth: a finite element study using nonlinear contact analysis.

This study considered the loading configuration of intact teeth by using finite element analyses to rationalize the clinical and biologic advantage inherent to posterior tooth shape. The biomechanical behavior of opposing molars was investigated in consideration of different loadcases simulating working, nonworking, and vertical closing micromotions starting in a position close to maximum intercuspation. The resulting stress distribution was assessed in a numerical model, reproducing 2-D buccolingual cross sections of maxillary and mandibular molars. In each case (working/nonworking/closure), the stroke was applied to the mandibular tooth in a stepping procedure (nonlinear contact analysis) until a total external force of 200 N was attained on the contact nodes. The principal stress distribution and modified Von Mises stresses were extracted from the postprocessing files. Vertical loading of the teeth did not generate harmful concentrations of stress. More challenging situations were encountered during working and nonworking micromotions, both of which generated inverted stress patterns. Supporting cusps were generally well protected during both working and nonworking cases (mostly subjected to compressive stresses). Nonsupporting cusps tended to exhibit more tensile stresses. High stress levels were found in the central groove of the maxillary molar during nonworking micromotion and at the lingual surface of enamel of the mandibular tooth during single-contact working micromotion. The occlusal load configuration as well as geometry and hard tissue arrangement had a marked influence on the stress distribution within opposing molars. Additional computations demonstrated the essential role of enamel bridges and crests to protect the crown from harmful tensile stresses.

Biomechanical Phenomena↗
PubMed1993

Staff support groups: do they support and are they even groups?

This article emphasizes the need to adopt a rigorous approach to the establishment of staff support groups. They are too important to be allowed to materialize without careful consideration of their aims, methods and composition. As a method of combating work-related stress they have a role to play, but it cannot be assumed that they will fulfil this role without serious attention being paid to these matters. There are good reasons for suspecting that improperly run support groups might have a harmful as well as a positive effect. As with all forms of help, the 'therapeutic' ingredients of support groups have to be identified and developed to ensure they fulfil their potential.

Female↗
PubMedDate not supplied

Saying "no" to environmental tobacco smoke: determinants of assertiveness among nonsmoking employees.

BACKGROUND: Nonsmokers' assertiveness can help regulate smoking in worksites by enhancing the salience of nonsmoking social norms. This study examined determinants of employees' assertiveness toward smoking colleagues. METHODS: Cross-sectional data were collected from 898 nonsmoking Dutch employees. Potential determinants were chosen using the attitude-social influence-efficacy model. RESULTS: Fifty-one percent of nonsmoking employees asked co-workers not to smoke. Assertive respondents had colleagues who more often acted assertively toward smokers at work, had a more positive attitude to asking colleagues not to smoke, and had a higher perceived self-efficacy. Moreover, assertive employees more often perceived hindrance from environmental tobacco smoke (ETS) and had more negative beliefs about ETS at work. CONCLUSIONS: What matters is whether ETS is perceived as bothersome and harmful. It is likely that both conditions must be met for nonsmokers to behave assertively. Worksite educational programs could focus more on increasing nonsmokers' awareness of the harmfulness of regular exposure to ETS at work to increase social pressure on employees who smoke in places that are shared by smokers and nonsmokers. However, the effectiveness of such strategies is yet unknown.

Adult↗
PubMed1994

The safe use of visual display units.

The use of visual display units (VDUs) has been increasing throughout the world in the last decade. The most common type of VDU uses the cathode ray tube, and this has resulted in concern among the public about possible adverse effects of radiation exposure from VDU use. Radiation emission from the VDU is negligible and has not been shown to be harmful to health, or to cause adverse pregnancy outcomes. However, many full-time VDU users often complain of visual discomfort, musculoskeletal discomfort of the neck, lower back and upper limbs, and psychosocial problems. The likelihood of having such complaints is positively associated with the duration of hours worked per day, the nature of the work, work schedules and workload, and workstation design and layout, rather than the VDU technology per se. Such complaints are often transient and resolve rapidly when stopping work. Other alleged adverse health effects of VDU use, such as skin complaints, have been discounted. Guidelines on the safe use of VDUs have been issued by various industrial corporations and national institutions. The guidelines generally address three main areas, viz (1) the provision of a suitable workstation and work environment, (2) good work technique and work schedules, and (3) preplacement and periodic health examinations for the detection and correction of personal impairments. The implementation of these guidelines will resolve many of the potentially correctable factors which result in many of the adverse health effects associated with VDU use.

Computer Terminals↗
PubMed2004

Summary of human responses to ventilation.

UNLABELLED: It is known that ventilation is necessary to remove indoor-generated pollutants from indoor air or dilute their concentration to acceptable levels. But as the limit values of all pollutants are not known the exact determination of required ventilation rates based on pollutant concentrations is seldom possible. The selection of ventilation rates has to be based also on epidemiological research, laboratory and field experiments and experience. The existing literature indicates that ventilation has a significant impact on several important human outcomes including: (1) communicable respiratory illnesses; (2) sick building syndrome symptoms; (3) task performance and productivity, and (4) perceived air quality (PAQ) among occupants or sensory panels (5) respiratory allergies and asthma. In many studies, prevalence of sick building syndrome symptoms has also been associated with characteristics of HVAC-systems. Often the prevalence of SBS symptoms is higher in air-conditioned buildings than in naturally ventilated buildings. The evidence suggests that better hygiene, commissioning, operation and maintenance of air handling systems may be particularly important for reducing the negative effects of HVAC systems. Ventilation may also have harmful effects on indoor air quality and climate if not properly designed, installed, maintained and operated. Ventilation may bring indoors harmful substances or deteriorate indoor environment. Ventilation interacts also with the building envelope and may deteriorate the structures of the building. Ventilation changes the pressure differences across the structures of building and may cause or prevent infiltration of pollutants from structures or adjacent spaces. Ventilation is also in many cases used to control the thermal environment or humidity in buildings. The paper summarises the current knowledge on positive and negative effects of ventilation on health and other human responses. The focus is on office-type working environment and residential buildings. PRACTICAL IMPLICATIONS: The review shows that ventilation has various positive impacts on health and productivity of building occupants. Ventilation reduces the prevalence of airborne infectious diseases and thus the number of sick leave days. In office environment a ventilation rate up to 20-25 L/s per person seem to decrease the prevalence of SBS-symptoms. Air conditioning systems may increase the prevalence of SBS-symptoms relative to natural ventilation if not clean. In residential buildings the air change rate in cold climates should not be below app. 0.5 ach. Ventilation systems may cause pressure differences over the building envelope and bring harmful pollutants indoors.

Air Conditioning↗
PubMedDate not supplied

Patient restraint positions in a psychiatric inpatient service.

AIM: The use of physical intervention on psychiatric inpatient units continues to be a source of debate and controversy. Some studies and national clinical guidelines have identified particular restraint positions as both dangerous and undesirable. The following study attempts to identify clinical variables that may make physical restraint in a particular position more likely. METHOD: A cross-sectional survey design was adopted and data was obtained from a violence and aggression audit form used by the trust. This form has 122 items to be completed by staff within 72 hours of an episode of patient aggression or self-harm. Ten variables were selected for scrutiny on the basis of their potential clinical importance. RESULTS: The survey found that prone restraint was significantly associated with others reporting the patient's imminent violence and high-intensity observation after the incident. Supine restraint was significantly associated with the patient being withdrawn and/or refusing to communicate prior to the episode and with a high severity incident rating after the incident. CONCLUSION: If we work on the premise that restraint in the prone position is less desirable than interventions undertaken with the patient in the supine position, this study clearly suggests that we have an opportunity to influence the nature of intervention through quite minimal changes to training programmes. It is important that any change in emphasis around intervention does not create a sense that controlled descent to the floor is inevitable. The principle of its use as a 'last resort in the event of loss of control on the feet' has to be maintained.

Aggression↗
PubMedDate not supplied

Why "do no harm"?

Edmund Pellegrino has argued that the dramatic changes in American health care call for critical reflection on the traditional norms governing the therapeutic relationship. This paper offers such reflection on the obligation to "do no harm." Drawing on work by Beauchamp and Childress and Pellegrino and Thomasma, I argue that the libertarian model of medical ethics offered by Engelhardt cannot adequately sustain an obligation to "do no harm." Because the obligation to "do no harm" is not based simply on a negative duty of nonmaleficence but also on a positive duty of beneficence, I argue that it is best understood to derive from the fiduciary nature of the healing relationship.

Beneficence↗
PubMed2003

Investigation of eye splash and needlestick incidents from an HIV-positive donor on an intensive care unit using root cause analysis.

BACKGROUND: Two doctors working on a busy intensive care unit sustained injuries whilst removing a chest drain from an HIV-positive patient. One doctor had a needlestick injury into his finger whilst the other sustained an eyesplash when the chest drain was pulled out. METHODS: Following Department of Health format 'Doing less harm', a root cause and human factor analysis of the incident was carried out. The aim was to explore the underlying issues. RESULTS AND CONCLUSIONS: Training, cultural and organizational issues were exposed, and are now being addressed. This approach has led to a far more effective dialogue with the National Health Trust concerned than was previously experienced, and there is early evidence of progress on important aspects of health and safety management at organizational level. Lack of health and safety training of doctors at undergraduate and postgraduate level needs to be addressed.

Accidents, Occupational↗
PubMedDate not supplied

Experimental studies of welfare reform and children.

Even prior to passage of federal welfare reform, many demonstration programs anticipated key features of the 1996 law, such as "work-first" strategies, time limits on welfare receipt, and financial incentives to work. Over the past decade, 10 experimental evaluations of these programs have extended their studies to examine the impacts on children. This article provides a synthesis of findings from the first seven of these studies to release results concerning child impacts. Key observations include the following: Across the different types of welfare-to-work programs examined, researchers found neither widespread harm nor widespread benefit to young children, but some significant impacts did occur. Favorable impacts tended to occur in programs that improved family economic status or maternal education, but these programs still did not bring children to the level of national norms for positive child development. Unfavorable impacts tended to occur when families did not show economic progress or when their economic situation worsened, when the children were adolescents, and--unexpectedly--when the families were believed to be at lower risk for long-term welfare receipt. Thus, although impacts were not widespread, these programs did have the potential to affect children for both better and worse across a range of developmental outcomes. The authors conclude that these findings underscore the importance of strengthening program approaches to enhance developmental outcomes for children in families being served by the welfare system.

Adolescent↗
PubMed2003

Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment.

BACKGROUND: Helicopter pilots usually work in unfavorable ergonomic positions, often with bulky head-worn equipment during flying missions. The purpose of this study was to evaluate and compare immediate muscle response in the dorsal neck muscles to different positions with a variety of head-worn equipment. METHODS: Fourteen healthy male helicopter pilots volunteered for this study. EMG activity in the upper and lower dorsal neck muscles and the trapezius muscle was measured in a laboratory situation for 5 s in different sitting positions (neutral, trunk inclined 20 degrees, neck flexed 20 degrees), including registration of a 30 degrees left and right rotation in every position; all measurements were performed while wearing a helmet, a helmet and night vision goggles (hNVG), and a helmet, night vision goggles, and counterweight (hCW), in random order. RESULTS: There was significant higher EMG activity in the upper neck with hNVG and hCW than with the helmet only when comparing the mean activity level of all positions. However, there was no significant difference in EMG activity between any variations of head-worn equipment when comparing activity levels during each position separately. In the upper and lower neck, respectively, there was significantly higher muscle activity during the ipsilateral rotated positions plus neck flexion and trunk inclination than in most other positions. CONCLUSION: The increased load caused by different positions seems to have a greater influence on muscle activity than the increased load of the head-worn equipment, which must be considered when designing helicopter work-places.

Adult↗