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The emergence of work-centred issues in consultative work: an observation.

During two separate series of consultative meetings for professionals engaged in direct work with adolescents, the authors noticed that the issues brought to consultation showed a definite and sustained shift away from matters to do with the workers' clientele, and towards matters concerning their working relationships and work settings. The possible causes and effects of this shift in the focus of work is discussed.

Adolescent↗

Work stress, socioeconomic status and neuroendocrine activation over the working day.

Socioeconomic status (SES) differences in cardiovascular and metabolic disease risk may be mediated in part by differential activation of neuroendocrine pathways. We have previously found that salivary cortisol levels over the working day are greater in lower than higher SES men, but that cortisol output is greater in higher than lower SES women. This study investigated the role of work stress in generating these patterns, analysing cortisol output in relation to job demands and job control. Participants were 97 men and 84 woman from the Whitehall II cohort, London, UK, recruited from higher and lower grades of employment. Saliva samples were obtained on waking and 30 min later to assess the cortisol waking responses, and at two hourly intervals over a typical working day. Cortisol responses to waking were positively associated with high job demands, but this effect was attenuated by higher SES. In women but not men, cortisol levels over the remainder of the day were elevated in lower SES participants who experienced high job demands, but depressed in lower status women who reported low job demands. Job control did not influence cortisol responses to waking, but in men cortisol levels over the remainder of the day were inversely related to job control. These cortisol differences were independent of age, smoking status and time of waking up. Subjectively, the most stress was reported by higher SES individuals who experienced low job control. We conclude that work stress and SES are related differently to cortisol responses to waking and cortisol output over the day. Job control may partly mediate SES differences in cortisol in men, while job demands are more relevant for women. Analyses of psychobiological pathways must take account of variations in exposure to chronic stressors as well as differences in responsivity to stressors.

Adaptation, Psychological↗

Language comprehension and working memory language comprehension and working memory deficits in patients with schizophrenia.

The present study examined the hypothesis that patients with schizophrenia have deficits in language comprehension compared to normal controls, and that these deficits are associated with disturbances in working memory (WM). In addition, we hypothesized that language comprehension deficits would be associated with the severity of specific symptoms in the patients (formal thought disorder and hallucinations). Participants were 27 stable outpatients with schizophrenia and 28 demographically similar controls. Language comprehension was measured by presenting sentences auditorily that varied in length and syntactic complexity, followed by two or three comprehension questions. We measured working memory by administering a reading span task. Results indicated that, as predicted, language comprehension deficits were significantly greater in patients with schizophrenia than controls. Also as predicted, working memory was strongly correlated with language comprehension performance in both patients with schizophrenia and controls. Contrary to our predictions, language comprehension and working memory deficits were not associated with either formal thought disorder or hallucinations.

Adult↗

Helping clinicians in work disability prevention: the work disability diagnosis interview.

Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disability resolution in patients absent from work due to a musculoskeletal disorder. Initial application demonstrated a high prevalence of sociodemographic, work-related, and psychosocial factors that may contribute to prolonged work absence.

Absenteeism↗

Is working memory still working?

The current state of A. D. Baddeley and G. J. Hitch's (1974) multicomponent working memory model is reviewed. The phonological and visuospatial subsystems have been extensively investigated, leading both to challenges over interpretation of individual phenomena and to more detailed attempts to model the processes underlying the subsystems. Analysis of the controlling central executive has proved more challenging, leading to a proposed clarification in which the executive is assumed to be a limited capacity attentional system, aided by a newly postulated fourth system, the episodic buffer. Current interest focuses most strongly on the link between working memory and long-term memory and on the processes allowing the integration of information from the component subsystems. The model has proved valuable in accounting for data from a wide range of participant groups under a rich array of task conditions. Working memory does still appear to be working.

Humans↗

How do people with different attachment styles balance work and family? A personality perspective on work-family linkage.

This study explored whether different models of work-family relationship were possible for individuals with different attachment styles. A mail survey was conducted using employees (N = 481) at a midwestern university in the United States. Results suggested that (a) individuals with a preoccupied attachment pattern were more likely to experience negative spillover from the family/home to the work domain than those with a secure or dismissing style, (b) securely attached individuals experienced positive spillover in both work and family domains more than those in the other groups, and (c) preoccupied individuals were much less likely to use a segmentation strategy than the other 3 attachment groups. However, when the conventional job satisfaction life satisfaction relationship was examined, the data provided unique support for the spillover model. Implications of the findings for both attachment and work family relationship literatures are discussed.

Adult↗

Donor work-up and transport of bone marrow--recommendations and requirements for a standardized practice throughout the world from the Donor Registries and Quality Assurance Working Groups of the World Marrow Donor Association (WMDA).

In October 1995 the World Marrow Donor Association (WMDA) was restructured in order to facilitate its primary function of establishing guidelines in relation to international bone marrow and blood stem cell transplants -- transplants in which the donor is in one country and the patient is in another country. Five new working groups were established -- Donor Registries, Ethics, Quality Assurance, Finances, and Stem Cells. This paper, prepared by members of the Donor Registries Working Group, in consultation with the Quality Assurance Working Group, provides recommendations for the 'donor work-up'. This term covers events that start when the definitive donor has been identified, includes the harvesting (collection) and transportation of the stem cell product and ends when the product reaches the transplant centre. The paper includes examples of the documentation intended to ensure compliance with the recommendations at all key points in the sequence.

Bone Marrow Transplantation↗

Predictors of return to work following traumatic work-related lower extremity amputation.

PURPOSE: To determine factors predictive of return to work (RTW) and days of total disability (TD) in a population of persons working at the time of lower extremity amputation. METHOD: Retrospective chart and database review. RESULTS: Of 88 valid cases, 48% involved toe amputation, 23% transtibial, 14% partial foot, 14% transfemoral, and 2% high level. Fifty-eight percent of all subjects RTW, 19% were deemed 'fit for work', and 23% did not RTW. Days TD ranged from 0 to 1664, with a mean of 366 days. Toe amputation level showed a mean of 127 days of TD. Bivariate analysis showed amputation level, total costs to Workers Compensation Board (WCB), and days TD significantly related to RTW, and rehabilitation costs, vocational rehabilitation, work assessment, age, number of surgical procedures, number of days in acute care, and amputation level significantly related to days TD. In the multivariate model, only amputation level and higher gross annual income showed predictive value for RTW. However older age, more surgical procedures, less days in hospital, and higher amputation levels were all predictive of increased days TD. CONCLUSION: Toe amputation level had a surprisingly high number of days TD, which may have significant potential economic and disability impact on the workplace. Other factors beyond simply amputation level (such as previous income level) are important considerations for RTW.

Accidents, Occupational↗

Field dependence-independence from a working memory perspective: a dual-task investigation of the Hidden Figures test.

Field dependence-independence (FDI) is a construct intensively investigated within cognitive style research, but its cognitive underpinnings are not clearly specified. We propose that performance on FDI tasks primarily reflects the operations of the visuospatial and executive components of working memory. We tested this hypothesis in a dual-task experiment with a commonly used measure of FDI, the Hidden Figures Test. The results showed that performance on this test was impaired by concurrent performance of secondary tasks that primarily tap the visuospatial component (spatial tapping) and the executive component (2-back and random number generation), but was almost unaffected by other secondary tasks (simple tapping and articulatory suppression). Moreover, an analysis of secondary task performance ruled out the possibility of strategic trade-offs and revealed an intriguing dissociation for two different sets of "randomness" indices for the random number generation task. These results support the hypothesised mapping between FDI and working memory components and suggest that the dual-task paradigm can provide a useful way to bring underspecified constructs like FDI into closer alignment with theoretical ideas developed within cognitive psychology.

Field Dependence-Independence↗

Ethnic background does not influence outcome for return-to-work in work-related interdisciplinary rehabilitation for long-term pain: 1- and 3-year follow-up.

BACKGROUND: It is often suggested that immigrants with long-term pain do not benefit from rehabilitation to the same extent as native Swedish patients. In this study, an 8-week rehabilitation programme was evaluated according to its adaptation for immigrants. OBJECTIVES: To establish whether there is a difference between immigrants and native Swedes concerning: (i) return-to-work, the patients' own estimation and their actual ability; (ii) higher level of activity; (iii) reduction in pain and analgesic use. PATIENTS: A total of 67 patients with persistent non-malignant pain completed the rehabilitation programme. Thirty (45%) of the patients were immigrants. METHODS: A 1- and a 3-year follow-up were made to compare the outcome between the 2 groups. RESULTS: There was no significant difference in the return-to-work rate between immigrants and native Swedes. However, the patients' prediction of their ability to return to work was higher among the non-immigrants. The level of activity was lower and pain intensity and use of analgesics were higher among the immigrants than the non-immigrants. CONCLUSION: Immigrants can benefit from a rehabilitation programme to the same extent as native Swedes concerning return-to-work rate, but seem to have limitations in assimilating the other objectives of the programme.

Adult↗

Building health promoting work settings: identifying the relationship between work characteristics and occupational stress in Australia.

Occupational stress is a serious threat to the health of individual workers, their families and the community at large. The settings approach to health promotion offers valuable opportunities for developing comprehensive strategies to prevent and reduce job stress. However, there is evidence that many workplace health promotion programs adopt traditional, lifestyle-oriented strategies when dealing with occupational stress, and ignore the impact that the setting itself has on the health of employees. The aim of the present study was to address two of the barriers to adopting the settings approach; namely the lack of information on how psycho-social work characteristics can influence health, and not having the confidence or knowledge to identify or address organizational-level issues. A comprehensive occupational stress audit involving qualitative and quantitative research methods was undertaken in a small- to medium-sized public sector organization in Australia. The results revealed that the work characteristics 'social support' and 'job control' accounted for large proportions of explained variance in job satisfaction and psychological health. In addition to these generic variables, several job-specific stressors were found to be predictive of the strain experienced by employees. When coupled with the results of other studies, these findings suggest that work characteristics (particularly control and support) offer valuable avenues for creating work settings that can protect and enhance employee health. The implications of the methods used to develop and complete the stress audit are also discussed.

Australia↗

Pathways into the work force: antecedents of school and work force status.

OBJECTIVE: The study aim was to identify risk factors for specific pathways into the work force using data from the Ontario Child Health Study Follow-up. METHOD: Potential predictor variables were derived from data collected in 1983 on adolescents aged 13 to 16 years. The subjects were followed up 4 years later and the school/work force outcome was determined. Bivariate and multivariate statistical analyses were used to identify variables with a strong independent association with this outcome. RESULTS: Subjects in the work force were four times more likely than those attending school to have come from a low-income family and at least two times more likely to have a family background of low maternal education, to have failed a grade, or to have used substances heavily during early adolescence. Subjects with two or more of these risk factors were likely to be in part-time work or unemployed. CONCLUSIONS: Preventive interventions should be targeted at children from poor families, or who fail at school, or show early onset of substance abuse and other deviant behaviors. Studies are needed to further elucidate the relationship between these risk factors and pathways into the work force and beyond.

Adolescent↗

Frequency and duration of absence from work as functions of work force characteristics.

The processes of sick-leave inception and work resumption are governed by many interrelated factors. Hence conventional univariate models of these processes do not provide an adequate basis for explanation and prediction. In this study, multivariate models were used to fit absenteeism data for a large government department. The variables considered were the age, sex, and grade of the employees concerned; the day, month, and year of inception of sick leave or resumption of work; the section in which the employees worked and the size of that section. The models were used to predict the rates of sick-leave inception and work resumption in a test set of employees. The predicted inception rates appear to agree well with the observed values.

Adult↗

Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys.

Associations between chronic conditions and work performance (absenteeism, presenteeism, and critical incidents) were studied in reservation agents, customer service representatives, executives, and railroad engineers. Conditions and work performance were assessed with the World Health Organization's Health and Work Performance Questionnaire. Analysis of covariance was used to estimate associations. More work performance was lost from presenteeism than absenteeism. However, chronic conditions more consistently had negative impacts on absenteeism than presenteeism. Conditions with significant effects included arthritis, asthma, chronic obstructive pulmonary disease-emphysema, depression, and chronic headaches. Arthritis had the largest aggregate effect on absenteeism-presenteeism. Only depression affected both absenteeism-presenteeism and critical incidents. Some chronic conditions have substantial workplace effects. Disease management programs for these conditions might have a positive return on investment (ROI). Health and productivity tracking surveys are needed to evaluate ROI and provide quality assurance.

Absenteeism↗

Neck, shoulder, and hand and wrist pain among administrative employees: relation to work-time organization and psychosocial factors at work.

OBJECTIVE: We sought to analyze the associations between work-time organization, psychosocial factors at work, and musculoskeletal pain of the neck, shoulders, and wrists and hands among administrative employees. METHODS: We analyzed the pain felt in a population of 762 employees during the 7 days before the survey at any of the three sites studied (multiple logistic regression). RESULTS: We found no associations between work-time organization and neck or shoulder pain. Wrist and hand pain increased with irregular schedule (odds ratio "OR" = 2.01; 95% confidence interval "95% CI" = 1.19-3.41) and lack of advance (at least 8 days) notice of schedule (OR = 1.90; 95% CI = 1.03-3.50). Of the psychosocial factors, only high psychological demand was associated with a significant increase in the prevalence of pain, in the neck and the shoulders (respectively: OR = 1.86, 95% CI = 1.23-2.82; OR = 1.88, 95% CI = 1.17-3.03). CONCLUSION: Prevention by improved psychosocial constraints at work must continue.

Adult↗

Pediatric farm injuries involving non-working children injured by a farm work hazard: five priorities for primary prevention.

OBJECTIVES: To describe pediatric farm injuries experienced by children who were not engaged in farm work, but were injured by a farm work hazard and to identify priorities for primary prevention. DESIGN: Secondary analysis of data from a novel evaluation of an injury control resource using a retrospective case series. DATA SOURCES: Fatal, hospitalized, and restricted activity farm injuries from Canada and the United States. SUBJECTS: Three hundred and seventy known non-work childhood injuries from a larger case series of 934 injury events covering the full spectrum of pediatric farm injuries. METHODS: Recurrent injury patterns were described by child demographics, external cause of injury, and associated child activities. Factors contributing to pediatric farm injury were described. New priorities for primary prevention were identified. RESULTS: The children involved were mainly resident members of farm families and 233/370 (63.0%) of the children were under the age of 7 years. Leading mechanisms of injury varied by data source but included: bystander and passenger runovers (fatalities); drowning (fatalities); machinery entanglements (hospitalizations); falls from heights (hospitalizations); and animal trauma (hospitalizations, restricted activity injuries). Common activities leading to injury included playing in the worksite (all data sources); being a bystander to or extra rider on farm machinery (all data sources); recreational horseback riding (restricted activity injuries). Five priorities for prevention programs are proposed. CONCLUSIONS: Substantial proportions of pediatric farm injuries are experienced by children who are not engaged in farm work. These injuries occur because farm children are often exposed to an occupational worksite with known hazards. Study findings could lead to more refined and focused pediatric farm injury prevention initiatives.

Adolescent↗

Work preferences as moderators of the effects of paced and unpaced work on mood and cognitive performance: a laboratory simulation of mechanized letter sorting.

This article describes a laboratory study of work preferences (ideal job demand and discretion levels) as moderators of the effects of paced and unpaced work on cognitive and affective responses. Posttest measures of cognitive performance and self-reported stress and arousal were used as outcome measures with covariance control for the corresponding pretest values. The experimental design allowed within-subjects contrasts of fast versus slow pacing and of machine-paced versus self-paced conditions. Self-paced performance compared favorably with machine-paced performance; however, individual differences in ideal demand influenced the relative speed of work under the two conditions. Work preferences also moderated relationships between pacing and outcome measures; ideal discretion moderated machine-pacing versus self-pacing effects in relation to cognitive performance and stress, and ideal demand moderated fast versus slow pacing effects in relation to arousal. These findings are discussed in relation to existing literature on pacing and on person-environment fit.

Adult↗

A national survey of health professionals and volunteers working in voluntary hospices in the UK. II. Staff and volunteers' experiences of working in hospices.

In this paper we report findings of a 1999 nationally representative survey of independent hospices in the UK, focusing on hospice staff and volunteers' experiences of working in hospices. Nineteen of 25 sampled services participated, and these differed little in terms of service provision, size and region from the total sample of 175 services. A response rate of 70% for randomly sampled hospice staff and volunteers was achieved (n=504). There were significant intergroup differences (doctors, nurses, nursing auxiliaries, other staff and volunteers) in participants' reported experience of working in the hospice with, for example, doctors being more likely than other groups to feel appreciated and to report receiving adequate support from hospice management. Overall, 31% of respondents wanted more support from management. Half had considered leaving the hospice (65% nurses, 60% other staff, 55% nursing auxiliaries, 40% doctors and 37% volunteers). Nurses who had considered leaving were less satisfied than other nurses with, for example, support from hospice management, and less likely to feel valued by the hospice. These results raise questions about the quality of the relationship between hospice trustees, managers and staff, and about the realities of enhancing multiprofessional teamwork in organizations where there are significant differences between staff groups in perception of, and satisfaction with, the working environment. Voluntary hospice trustees and managers face a difficult task in managing and supporting staff whilst also negotiating relationships with the NHS at a time of rapid change, and ensuring hospices' financial viability. Access to high quality leadership programmes may play an important role in ensuring voluntary hospices are characterized by effective, supportive working relationships.

Adaptation, Physiological↗