The effectiveness of health education using the teach-back method on adherence and self-management in chronic disease: A systematic review protocol

Review question/objective What is the effect of using the teach-back method for health education to improve adherence to treatment regimen and self-management in chronic disease? Inclusion criteria Types of participants This review will consider all studies that include adult patients (aged 18 years and over) in any healthcare setting, either as inpatients (eg acute care, medical and surgical wards) or those who attend primary health care, family medical practice, general medical practice, clinics, outpatient departments, rehabilitation or community settings. Participants need to have been diagnosed as having one or more chronic diseases including heart failure, diabetes, cardiovascular disease, cancer, respiratory disease, asthma, chronic obstructive pulmonary disease, chronic kidney disease, arthritis, epilepsy or a mental health condition. Studies that include seriously ill patients, and/or those who have impairments in verbal communication and cognitive function will be excluded. Types of intervention This review will consider studies that investigate the use of the teach-back method alone or in combination with other supporting education, either in routine or research intervention education programs; regardless of how long the programs were and whether or not a follow-up was conducted. The intervention could be delivered by any healthcare professional. The comparator will be any health education for chronic disease that does not include the teach-back method. Types of outcomes Primary outcomes of interest are disease-specific knowledge, adherence, and self-management knowledge, behavior and skills measured using patient report, nursing observation or validated measurement scales. Secondary outcomes include knowledge retention, self-efficacy, hospital readmission, hospitalization, and quality of life, also measured using patient report, nursing observation, hospital records or validated measurement scales.

Safety management in repair, maintenance, minor alteration, and addition works : knowledge management perspective

Safety of repair, maintenance, alteration, and addition (RMAA) works have long been neglected because RMAAworks are often minute and only last for a short period of time. With rising importance of the RMAA sector in many developed societies, safety of RMAA works has begun to draw attention. Many RMAA contracting companies are small- and medium-sized enterprises (SMEs) that do not have comprehensive safety management systems. Existing safety legislation and regulations for new construction sites are not fully applicable to RMAAworks. Instead of relying on explicit and well-established safety systems, tacit safety knowledge plays an extremely important role in RMAA projects. To improve safety of RMAAworks, safety knowledge should be better managed. However, safety knowledge is difficult to capture in RMAA works. This study aims to examine safety management practices of RMAA contracting companies to see how safety knowledge of RMAA projects is managed. Findings show that RMAA contracting companies undertaking large-scale RMAA projects have more initiatives of safety management. Safety management of small-scale RMAA works relies heavily on the motivation of site supervisors and self-regulation of workers. Better tacit knowledge management improves safety performance. To enhance safety capability of RMAA contracting companies, a knowledge sharing culture should be cultivated. The government should provide assistance to SMEs to implement proper safety management practices in small-sized projects. Potentials of applying computer software technology in RMAA projects to capture, store, and retrieve safety information should be explored. Employees should be motivated to share safety knowledge by giving proper recognition to those who are willing to share.

Safety climate and injury occurrence of repair, maintenance, minor alteration and addition works : a comparison of workers, supervisors and managers

Purpose The repair, maintenance, minor alteration and addition (RMAA) sector has been expanding in many developed cities. Safety problems of the RMAA sector have attracted the attention of many governments. This study has the objectives of comparing the level of safety climate of workers, supervisors and managers in the RMAA sector; and explaining/ predicting the impact of safety climate on injury occurrence of workers, supervisors and managers. Design/methodology/approach A questionnaire survey was administered to RMAA contracting companies in Hong Kong. Findings When comparing the safety climate perception of workers, supervisors and managers in the RMAA sector, the supervisors group had the lowest mean safety climate score. Results showed that a positive workforce safety attitude and acceptance of safety rules and regulations reduced the workers’ likelihood of having injuries. A reasonable production schedule led to a lower probability of supervisors being injured. Management commitment and effective safety management reduced the probability of managers being injured. Originality/value This study revealed variations of safety climate at the different levels in the organizational hierarchy and their varying influence on safety performance of the RMAA sector. Safety of RMAA works could be improved by promulgating specific safety measures at the different hierarchy levels.

Experimental and numerical characteristics of portable water-filled road safety barrier system under different impact conditions

This research has developed an innovative road safety barrier system that will enhance roadside safety. In doing so, the research developed new knowledge in the field of road crash mitigation for high speed vehicle impact involving plastic road safety barriers. This road safety barrier system has the required feature to redirecting an errant vehicle with limited lateral displacement. Research was carried out using dynamic computer simulation technique support by experimental testing. Future road safety barrier designers may use the information in this research as a design guideline to improve the performance and redirectional capability of the road safety barrier system. This will lead to better safety conditions on the roadways and potentially save lives.

Eldercare demands, mental health, and work performance : the moderating role of satisfaction with eldercare tasks

Due to demographic changes, a growing number of employees provide in-home care to an elderly family member. Previous research suggested a negative relationship between employees' eldercare demands and their work performance. However, the empirical nature of this relationship and its boundary conditions and mediating mechanisms have been neglected. The goal of this multisource study was to examine a mediated-moderation model of eldercare demands, mental health, and work performance. Drawing on the theory of conservation of resources (Hobfoll, 1989), it was expected that employees' satisfaction with eldercare tasks would buffer the negative relationship between eldercare demands and work performance, and that mental health would mediate this moderating effect. Data were collected from 165 employees providing in-home eldercare, as well as from one colleague and one family member of each employee. Results of mediated-moderation analyses supported the hypothesized model. The findings suggest that interventions that aim to increase employees' satisfaction with eldercare tasks may help protect employees from the negative effects of high eldercare demands on mental health and, subsequently, on work performance.

A review of the profile of endothelin axis in cancer and its management

The endothelins and their associated receptors are important controllers of vascular growth, inflammation and vascular tone. In cancer, they have roles in the control of numerous factors in cancer development and progression, including angiogenesis, stromal reaction, epithelial mesenchymal transitions, apoptosis, invasion, metastases and drug resistance. Also, we consider current information on the role of this signalling system in cancer and examine the state of the current cell, animal and clinical trials utilizing endothelin targeted drugs for cancer management. Although targeting the endothelin axis in cell lines and xenografts show some promise in retarding cellular growth, results from limited clinical trials in prostatic cancer are less encouraging and did not offer significant survival benefit. The ability to target both cancer cells and vasculature via endothelin is an important consideration that necessitates the further refining of therapeutic strategies as we continue to explore the possibilities of the endothelin axis in cancer treatment.

Industry based rehabilitation and closure knowledge management system : scoping study

The Central Queensland Mine Rehabilitation Group (CQMRG) has hosted mine site rehabilitation inspections combined with technical workshops for more than 20 years. It was recognised at CQMRG's anniversary meeting in April 2013 that the vast body of knowledge held by rehabilitation and closure planning practitioners was being lost as senior rehabilitation experts retire from the industry. It was noted that even more knowledge could be readily lost unless a knowledge management platform was developed to capture, store and enable retrieval of this information. This loss of knowledge results in a significant cost to industry. This project was therefore undertaken to review tools which have the capability to gather the less formal knowledge as well as to make links to existing resources and bibliographic material. This scoping study evaluated eight alternative knowledge management systems to provide guidance on the best method of providing the industry with an up-to-date, good practice, knowledge management system for rehabilitation and closure practices, with capability for information sharing via a portal and discussion forum. This project provides guidance for a larger project which will implement the knowledge management system to meet the requirements of the CQMRG and be transferrable to other regions if applicable. It will also provide the opportunity to identify missing links between existing tools and their application. That is, users may not be aware of how these existing tools can be used to assist with mine rehabilitation planning and implementation and the development of a new platform will help to create those linkages. The outcomes of this project are directed toward providing access to a live repository of rehabilitation practice information which is Central Queensland coal mine-specific, namely: highlighting best practice activities, results of trials and innovative practices; updated legislative requirements; links to practices elsewhere; and informal anecdotal information relevant to particular sites which may be of assistance in the development of rehabilitation of new areas. Solutions to the rehabilitation of challenging spoils/soils will also be provided. The project will also develop a process which can be applied more broadly within the mining sector to other regions and other commodities. Providing a platform for uploading information and holding discussion forums which can be managed by a regional practitioner network enables the new system to be kept alive, driven by users and information needs as they evolve over time. Similar internet-based platforms exist and are managed successfully. The preferred knowledge management system will capture the less formal and more difficult to access knowledge from rehabilitation and mine closure practitioners and stakeholders through the CQMRG and other contributors. It will also provide direct links, and greater accessibility, to more formal sources of knowledge with anticipated cost savings to the industry and improved rehabilitation practices with successful transitioning to closure and post-mining land use.

European aspects of standard setting in occupational hygiene and medicine

Occupational standards concerning the allowable concentrations of chemical compounds in the ambient air of workplaces have been established in several countries at national levels. With the integration of the European Union, a need exists for establishing harmonized Occupational Exposure Limits. For analytical developments, it is apparent that methods for speciation or fractionation of carcinogenic metal compounds will be of increasing practical importance for standard setting. Criteria of applicability under field conditions, cost-effectiveness, and robustness are practical driving forces for new developments. When the European Union issued a list of 62 chemical substances with Occupational Exposure Limits in 2000, 25 substances received a 'skin' notation. The latter indicates that toxicologically significant amounts may be taken up via the skin. Similar notations exist on national levels. For such substances, monitoring concentrations in ambient air will not be sufficient; biological monitoring strategies will gain further importance in the medical surveillance of workers who are exposed to such compounds. Proceedings in establishing legal frameworks for a biological monitoring of chemical exposures within Europe are paralleled by scientific advances in this field. A new aspect is the possibility of a differential adduct monitoring, using blood proteins of different half-life or lifespan. This technique allows differentiation between long-term mean exposure to reactive chemicals and short-term episodes, for example, by accidental overexposure. For further analytical developments, the following issues have been addressed as being particularly important: New dose monitoring strategies, sensitive and reliable methods for detection of DNA adducts, cytogenetic parameters in biological monitoring, methods to monitor exposure to sensitizing chemicals, and parameters for individual susceptibilities to chemical toxicants.

Proactive behavior-based safety management for construction safety improvement

Construction is one of the most hazardous industries due to its dynamic, temporary, and decentralized nature. The Hong Kong Commissioner for Labor identifies worker behavior as the root cause of construction accidents. Behavior-based safety (BBS) is one effective approach in managing employee safety issues. However, there is little research on the application of BBS in the construction industry. This research proposes an extension of the BBS approach, proactive behavior-based safety (PBBS), to improve construction safety. PBBS integrates the theory of BBS with the technology of Proactive Construction Management System (PCMS). The innovations of PBBS are: (1) automatically monitoring location-based behaviors; (2)quantitatively measuring safety performance; (3) investigating potential causes of unsafe behaviors; and (4) improving the efficiency of safety management. A pilot study of a Hong Kong construction site practicing PBBS was conducted. The experiment results showed that PBBS performed well on construction accident prevention and the Safety Index (SI) of the two project teams, with increased improvements by 36.07% and 44.70% respectively. It is concluded that PBBS is effective and adaptable to construction industry.

Road safety and pavement management: A case study of Tanzania

The implementation of pavement management seems to ignore road safety, with its focus being mainly on infrastructure condition. Safety management as part of pavement management should consider various means of reducing the frequency of vehicle crashes by allocating corrective measures to mitigate accident exposure, as well as reduce accident severity and likelihood. However, it is common that lack of accident records and crash contributing factors impedes incorporating safety into pavement management. This paper presents a case study for the initial development of pavement management systems considering data limitations for 3000 km of Tanzania’s national roads. A performance based optimization utilizes indices for safety and surface condition to allocate corrective measures. A modified Pareto analysis capable of accounting for annual performance and of balancing resources to achieve good surface condition and low levels of safety was applied. Tradeoff analysis for the case study found the need to assign 30% relevance to condition and 70% to road safety. Safety and condition deficiencies were corrected within 5 years with the majority of improvements dedicated to surface treatments and some geometric corrections. Large investments for correcting geometric issues were observed in years two and three if more money was made available.

Workplace stress and its impact analysis for strategic stress management in construction projects

Workplace stress has been an increasing concern in the construction industry. Workers are working longer hours and construction managers’ responsibilities are becoming more complex and complicated due to reduced resources and widespread stakeholder involvements. These additional pressures potentially trigger workplace stress and impact on project performance. The purpose of this study is to examine and advance understanding of stress and its impact relationships that support holistic and strategic stress management. 17 key stress sources are identified with their impact relationships on different stress types examined. Based on the research findings, this paper concludes with a Stressor-Stress-Performance relationships map.

The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: A systematic review

- BACKGROUND Chronic diseases are increasing worldwide and have become a significant burden to those affected by those diseases. Disease-specific education programs have demonstrated improved outcomes, although people do forget information quickly or memorize it incorrectly. The teach-back method was introduced in an attempt to reinforce education to patients. To date, the evidence regarding the effectiveness of health education employing the teach-back method in improved care has not yet been reviewed systematically. - OBJECTIVES This systematic review examined the evidence on using the teach-back method in health education programs for improving adherence and self-management of people with chronic disease. - INCLUSION CRITERIA Types of participants: Adults aged 18 years and over with one or more than one chronic disease. Types of intervention: All types of interventions which included the teach-back method in an education program for people with chronic diseases. The comparator was chronic disease education programs that did not involve the teach-back method. Types of studies: Randomized and non-randomized controlled trials, cohort studies, before-after studies and case-control studies. Types of outcomes: The outcomes of interest were adherence, self-management, disease-specific knowledge, readmission, knowledge retention, self-efficacy and quality of life. - SEARCH STRATEGY Searches were conducted in CINAHL, MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, ProQuest Nursing and Allied Health Source, and Google Scholar databases. Search terms were combined by AND or OR in search strings. Reference lists of included articles were also searched for further potential references. - METHODOLOGICAL QUALITY Two reviewers conducted quality appraisal of papers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. - DATA EXTRACTION Data were extracted using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument data extraction instruments. - DATA SYNTHESIS There was significant heterogeneity in selected studies, hence a meta-analysis was not possible and the results were presented in narrative form. - RESULTS Of the 21 articles retrieved in full, 12 on the use of the teach-back method met the inclusion criteria and were selected for analysis. Four studies confirmed improved disease-specific knowledge in intervention participants. One study showed a statistically significant improvement in adherence to medication and diet among type 2 diabetics patients in the intervention group compared to the control group (p < 0.001). Two studies found statistically significant improvements in self-efficacy (p = 0.0026 and p < 0.001) in the intervention groups. One study examined quality of life in heart failure patients but the results did not improve from the intervention (p = 0.59). Five studies found a reduction in readmission rates and hospitalization but these were not always statistically significant. Two studies showed improvement in daily weighing among heart failure participants, and in adherence to diet, exercise and foot care among those with type 2 diabetes. - CONCLUSION Overall, the teach-back method showed positive effects in a wide range of health care outcomes although these were not always statistically significant. Studies in this systematic review revealed improved outcomes in disease-specific knowledge, adherence, self-efficacy and the inhaler technique. There was a positive but inconsistent trend also seen in improved self-care and reduction of hospital readmission rates. There was limited evidence on improvement in quality of life or disease related knowledge retention.

Using Big Data to manage safety-related risk in the upstream oil and gas industry: A research agenda

Despite considerable effort and a broad range of new approaches to safety management over the years, the upstream oil & gas industry has been frustrated by the sector’s stubbornly high rate of injuries and fatalities. This short communication points out, however, that the industry may be in a position to make considerable progress by applying “Big Data” analytical tools to the large volumes of safety-related data that have been collected by these organizations. Toward making this case, we examine existing safety-related information management practices in the upstream oil & gas industry, and specifically note that data in this sector often tends to be highly customized, difficult to analyze using conventional quantitative tools, and frequently ignored. We then contend that the application of new Big Data kinds of analytical techniques could potentially reveal patterns and trends that have been hidden or unknown thus far, and argue that these tools could help the upstream oil & gas sector to improve its injury and fatality statistics. Finally, we offer a research agenda toward accelerating the rate at which Big Data and new analytical capabilities could play a material role in helping the industry to improve its health and safety performance.

Safety of Repair, Maintenance, Minor Alteration, and Addition (RMAA) Works: A New Focus of Construction Safety

"Safety of RMAA works is an almost uncharted topic of rising importance internationally. Small construction contractors are particularly dependant on RMAA work, especially during times of recession, and they undertake more risks on these jobs than large companies do. This book is based on unique international research and consultancy projects which detail, investigate, and suggest solutions to the specific challenges of safety in RMAA works, based on case studies. Starting with an overview of safety in the wider construction industries of developed countries, the first half of this book also provides a comprehensive summary of relevant rules, regulations, and the resulting safety performances. The systems in the UK, US and Hong Kong are described and contrasted, giving the reader an understanding of how different regulatory approaches have yielded a variety of results. From this solid introduction, specific problems observed in RMAA work are examined through case studies, with reference to the underlying cultural and demographic factors, and a variety of practical engineering and management solutions are explored. This important and practical international work is essential reading for postgraduate students of health and safety in construction, construction project management, or construction in developing countries, as well as policy-makers and construction project managers."--Publisher website