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Biomedical subjects

Benjamin C Amick

Publications and source records attributed to Benjamin C Amick.

28 records · Page 2Linked to original sources

Relationship of employee-reported work limitations to work productivity.

BACKGROUND: Work limitation rates are crucial indicators of the health status of working people. If related to work productivity, work limitation rates may also supply important information about the economic burden of illness. OBJECTIVE: Our objective was to assess the productivity impact of on-the-job work limitations due to employees' physical or mental health problems. RESEARCH DESIGN: Subjects were asked to complete a self-administered survey on the job during 3 consecutive months. Using robust regression analysis, we tested the relationship of objectively-measured work productivity to employee-reported work limitations. SUBJECTS: We attempted to survey employees of a large firm within 3 different jobs. The survey response rate was 2245 (85.9%). Full survey and productivity data were available for 1827 respondents. MEASURES: Each survey included a validated self-report instrument, the Work Limitations Questionnaire (WLQ). The firm provided objective, employee-level work productivity data. RESULTS: In adjusted regression analyses (n = 1827), employee work productivity (measured as the log of units produced/hour) was significantly associated with 3 dimensions of work limitations: limitations handling the job's time and scheduling demands (P = 0.003), physical job demands (P = 0.001), and output demands (P = 0.006). For every 10% increase in on-the-job work limitations reported on each of the 3 WLQ scales, work productivity declined approximately 4 to 5%. CONCLUSION: Employee work limitations have a negative impact on work productivity. Employee assessments of their work limitations supply important proxies for the economic burden of health problems.

Adolescent↗

Socioeconomic status and mortality among the elderly: findings from four US communities.

The effect of socioeconomic status (SES) on mortality was examined in the community-dwelling elderly. Data were obtained from four population-based studies that enrolled elderly residents of four US communities (East Boston, Massachusetts; New Haven, Connecticut; east-central Iowa; and the Piedmont region of North Carolina) and followed them for 9 years, starting in 1982 or 1986. Higher SES, whether measured by education, by household income, or by occupational prestige, was generally associated with lower mortality. However, the pattern of findings varied by gender and by community. For men, all three SES indicators were associated with mortality in the majority of cohorts. For women, this was true only for income. SES-mortality associations were attenuated but not eliminated after adjustment for behavior and health status. SES-mortality associations were stronger in New Haven and North Carolina than in East Boston and Iowa. The latter communities are more homogeneous with respect to ethnicity, urbanization, and occupational history than the former. Future research should investigate the relative validity of traditional SES measures for men and women and develop more balanced assessment methods. These findings also suggest that it is important to consider not only individual characteristics but also community attributes that mediate or modify the pathways through which socioeconomic conditions may influence health.

Aged↗

Assessment of upper extremity role functioning in students.

BACKGROUND: Upper extremity symptoms associated with use of computers and other upper extremity activities are common in students. Research on these disorders requires psychometrically sound measures of health-related student role function; no such measure is available currently. METHODS: Based upon input from students and clinicians, we developed a 10-item scale to measure student health-related role function. The measure was administered as part of a survey of 193 undergraduates at one university. A follow-up survey was administered 1 month later. The student health-related role function questionnaire was assessed for internal consistency, ceiling effects, convergent and discriminant validity, and responsiveness to self-reported change in functional status. RESULTS: Eighty-two percent of students who were given the survey completed it and 65% completed a follow-up survey 1 month later. The new measure was reliable (Cronbach's alpha 0.87). Forty-six percent of respondents reported "no difficulty" on all items of the health-related student role function measure while 64% reported "no difficulty" on all items of a generic upper extremity functional status measure. This finding indicates that the new measure was better able to detect functional limitations; it had a less prominent ceiling effect. The new measure had moderately high correlations with measures of symptom severity and pain, documenting convergent validity. It distinguished students who utilized clinician services, medications, or academic accommodation from students who did not utilize these resources, documenting discriminant validity. The measure was responsive to self-perceived change, as demonstrated by a highly significant association (P < 0.0001) between changes in score over a 1-month follow-up and students' perceptions of whether they had improved in functional abilities after the month, deteriorated or remained stable. CONCLUSIONS: The student health-related role functioning measure is reliable, valid and responsive to change. It is an appropriate measure for research on upper extremity symptoms in students.

Arm↗

Employer, physical therapist, and employee outcomes in the management of work-related upper extremity disorders.

The purpose of this study was to investigate the relationship among employer, provider, and patient outcome measures and how they are related to clinical factors and other occupation-related factors. Data were obtained from a New England workplace physical therapy (PT) clinic. Successful outcomes were defined as remaining-on/returning-to preinjury job (employer); achieving PT goals (provider); and increases in the SF-36 scale scores (patient). Variation in outcomes was explored across injury regions (shoulder, elbow, wrist/hand), work categories, number of visits, and length of PT care. Employer and provider outcomes are moderately correlated (phi coefficient = 0.51). Subjects demonstrated significant improvements in the SF-36 physical functioning and bodily pain scores after physical therapy intervention. Patients with elbow disorders needed more PT care and did not improve in the SF-36 role physical domain compared to shoulder and wrist/hand groups (p < 0.05). Our results describe the relationship between outcome measures from different perspectives and the influence from other contributing factors. The impact of workplace injury management and the selection of outcome measures warrant continued study.

Adult↗

Longer distal motor latency predicts better outcomes of carpal tunnel release.

The association of preoperative median nerve distal latencies with surgical outcomes of carpal tunnel release is unclear. A total of 109 surgically treated workers with carpal tunnel syndrome across the state of Maine completed questionnaires assessing preoperative levels of symptom and functional limitations and general physical health (SF-12). A second questionnaire assessed the 6-month postoperative outcomes of symptom severity, functional limitations, and satisfaction with surgery. Univariate analyses indicated that longer preoperative distal motor and sensory latencies were associated with less postoperative levels of symptom, less postoperative functional limitations, and more satisfaction with surgery. The associations persisted in multiple linear regression analysis; however, better general health preoperatively was a better predictor of favorable outcomes. The results suggest that workers with prolonged preoperative distal motor latencies and who are in good general health preoperatively have a higher rate of successful carpal tunnel release surgery.

Adult↗

Office-based medical care for work-related conditions: findings from the National Ambulatory Medical Care Survey, 1997-1998.

Data from the 1997 and 1998 National Ambulatory Medical Care Surveys were analyzed to describe nationally representative patterns of office-based ambulatory medical care for work-related injuries and illnesses. Key dimensions of care included patient demographics, diagnoses, utilization of services, provider and payer information, and characteristics of the clinical setting in which care was delivered. Multivariate analyses revealed that compared to visits for nonwork related conditions, ambulatory care visits for work-related conditions are more likely to involve x-rays, injury prevention counseling, and physiotherapy. Surgical procedures, mental health counseling, prescription drug medication, and the taking of blood pressure were found to be relatively less common. Additionally, authorization for care was required considerably more often at visits for work-related conditions, and the provider for patients with work-related conditions was less likely to be the patient's regular primary care physician.

Ambulatory Care↗

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.

Adult↗

An invisible disability: Qualitative research on upper extremity disorders in a university community.

OBJECTIVES: To understand how upper extremity disorders related to computer use affect graduate and undergraduate university students; and, to develop hypotheses for prevention and management of these disorders. METHODS: Focus group discussions concerning upper extremity disorders were conducted among sixteen symptomatic undergraduate and graduate students at a private university in the US. Discussions were tape recorded, transcribed, coded for themes, and analyzed qualitatively. RESULTS: The findings point to four main themes: 1). the essential role of computers in academic, social, and personal activities; 2). the negative impact of upper extremity disorders on students' physical and emotional well-being, including their career aspirations; 3). students' expectations and perceptions of medical care providers; and 4). recommendations for interventions. CONCLUSION: Students with upper extremity disorders experience numerous adverse consequences on a college campus. Effective strategies for prevention, and treatment of upper extremity disorders in young adults in universities are needed. Based on this research, an educational and skills development intervention would appear to be appropriate for preventing disability due to upper extremity disorders.

Adult↗

Evaluation of an upper extremity student-role functioning scale using item response theory.

Millions of workers suffer from upper extremity (musculoskeletal) disorders. Many of these workers are predisposed to upper extremity musculoskeletal disorders because of early exposure to ergonomic risks as students. Computer usage for four or more hours remains the greatest risk for upper extremity musculoskeletal disorders for workers and students alike. Developing preventative methods to reduce student exposure, and thus protect future workers from upper extremity musculoskeletal disorders later in life, requires an appropriate measure for upper extremity musculoskeletal disorder prevalence and related limitations for student functioning. Item response theory analysis was used to evaluate and further develop a upper extremity functioning scale for the student role.

Adult↗

Relationship between all-cause mortality and cumulative working life course psychosocial and physical exposures in the United States labor market from 1968 to 1992.

OBJECTIVE: To examine the relationship between cumulative exposures to psychosocial and physical work conditions and mortality in a nationally representative sample. METHODS: A working cohort was created using the U.S. Panel Study of Income Dynamics. Information on psychosocial and physical work conditions were imputed using the Job Characteristics Scoring System exposure matrix for the period 1968 through 1991 to construct working life courses. Deaths were ascertained from 1970 through 1992. RESULTS: Working in low-control jobs for a working life was associated with a 43% increase in the chance of death (OR, 1.43, 1.13-1.81) assuming a 10-year time lag. No significant effect was found for high-strain work (ie, high psychosocial job demands and low job control), but a relationship was found between passive work (ie, low psychosocial job demands and low job control) and mortality (OR, 1.35, 1.06-1.72). No significant risk of death was found for psychosocial or physical job demands, job security, or work-related social support. Retirement (OR, 2.85, 1.59-5.11) and unemployment (OR, 2.26, 1.65-3.10) transitions and baseline disability (OR, 1.38, 1.06-1.79) predicted mortality. CONCLUSIONS: The results support the importance of job control to health. The passive work effect suggests that job content may be important in shaping a worker's health over the life course. Future research should focus on modeling stressors over the life course to capture the dynamic interplay of life transitions, stressor intensity and duration and the role of health in the interplay.

Adult↗