An epidemiologic evaluation of a worksite based intervention

The healthcare industry spends billions on worker injury and employee turnover. Hospitals and healthcare settings have one of the highest rates of lost days due to injuries. The occupational hazards for healthcare workers can be classified into biological, chemical, ergonomic, physical, organizational, and psychosocial. Therefore, interventions addressing a range of occupational health risks are needed to prevent injuries and reduce turnover and reduce costs. ^ The Sacred Vocation Program (SVP) seeks to change the content of work, i.e., the meaningfulness of work, to improve work environments. The SVP intervenes at both the individual and organizational level. First the SVP attempts to connect healthcare workers with meaning from their work through a series of 5 self-discovery group sessions. In a sixth session the graduates take an oath recommitting them to do their work as a vocation. Once motivated to connect with meaning in their work, a representative employee group meets in a second set of five meetings. This representative group suggests organizational changes to create a culture that supports employees in their calling. The employees present their plan in the twelfth session to management beginning a new phase in the existing dialogue between employees and management. ^ The SVP was implemented in a large Dallas hospital (almost 1000 licensed beds). The Baylor University Medical Center (BUMC) Pastoral Care department invited front-line caregivers (primarily Patient Care Assistants, PCAs, or Patient Care Technicians, PCTs) to participate in the SVP. Participants completed SVP questionnaires at the beginning and following SVP implementation. Following implementation, employer records were collected on injury, absence and turnover to further evaluate the program's effectiveness on metrics that are meaningful to managers in assessing organizational performance. This provided an opportunity to perform an epidemiological evaluation of the intervention using the two sources of information: employee self-reports and employer administrative data. ^ The ability to evaluate the effectiveness of the SVP on program outcomes could be limited by the strength of the measures used. An ordinal CFA performed on baseline SVP questionnaire measurements examined the construct validity and reliability of the SVP scales. Scales whose item-factor structure was confirmed in ordinal CFA were evaluated for their psychometric properties (i.e., reliability, mean, ceiling and floor effects). CFA supported the construct validity of six of the proposed scales: blocks to spirituality, meaning at work, work satisfaction, affective commitment, collaborative communication, and MHI-5. Five of the six scales confirmed had acceptable measures of reliability (all but MHI-5 had α>0.7). All six scales had a high percentage (>30%) of the scores at the ceiling. These findings supported the use of these items in the evaluation of change although strong ceiling effects may hinder discerning change. ^ Next, the confirmed SVP scales were used to evaluate whether the intervention improved program constructs. To evaluate the SVP a one group pretest-posttest design compared participants’ self-reports before and after the intervention. It was hypothesized that measurements of reduced blocks to spirituality (α = 0.76), meaning at work (α = 0.86), collaborative communication (α = 0.67) and SVP job tasks (α = 0.97) would improve following SVP implementation. The SVP job tasks scale was included even though it was not included in the ordinal CFA analysis due to a limited sample and high inter-item correlation. Changes in scaled measurements were assessed using multilevel linear regression methods. All post-intervention measurements increased (increases <0.28 points) but only reduced blocks to spirituality was statistically significant (0.22 points on a scale from 1 to 7, p < 0.05) after adjustment for covariates. Intensity of the intervention (stratifying on high participation units) strengthened effects; but were not statistically significant. The findings provide preliminary support for the hypothesis that meaning in work can be improved and, importantly, lend greater credence to any observed improvements in the outcomes. (Abstract shortened by UMI.)^

A knowledge based framework to support active aging at home based environments

Information and Communication Technologies can support Active Aging strategies in a scenario like the Smart Home. This paper details a person centered distributed framework, called TALISMAN+, whose aim is to promote personal autonomy by taking advantage of knowledge based technologies, sensors networks, mobile devices and internet. The proposed solution can support an elderly person to keep living alone at his house without being obliged to move to a residential center. The framework is composed by five subsystems: a reasoning module that is able to take local decisions at home in order to support active aging, a biomedical variables telemonitorisation platform running on a mobile device, a hybrid reasoning middleware aimed to assess cardiovascular risk in a remote way, a private vision based sensor subsystem, and a secure telematics solution that guarantees confidentiality for personal information. TALISMAN+ framework deployment is being evaluated at a real environment like the Accessible Digital Home.

Exercise-based intervention to prevent excessive gestational

El ejercicio en el embarazo.

Neighborhood mobility: A Long-Gone Pardigm? Approaching proximity and land use mix using data from home based surveys.

El WCTR es un congreso de reconocido prestigio internacional en el ámbito de la investigación del transporte y aunque las actas publicadas están en formato digital y sin ISSN ni ISBN, lo consideramos lo suficientemente importante como para que se considere en los indicadores. Policies trying to increase walking within urban mobility modal split usually highlight the importance of the functional patterns and the environmental quality of the urban space as major drivers of citizens modal choices. Functional characteristics would be mainly associated to an appropriate mix of land uses within neighbourhoods, whereas environmental quality would be associated to the characteristics of urban spaces. The purpose of this research is threefold: first, to identify relevant proxy indicators, which could characterize pedestrian-friendly land use mix and environmental quality. Second, to assess, for both traits, existing disparities among neighbourhoods in a major metropolitan area. And finally, to explore the association between both indicators and children mobility patterns: according to their built environment, which neighbourhoods have a greater proportion of children and, how is their mobility? Using data from the 2004 household mobility survey in the 128 neighbourhoods of the municipality of Madrid, this paper concludes that potentially favourable conditions at the neighbourhood level seem to have only a modest influence in,mobility patterns , in terms of both, selection of closer destinations and a higher share of walking within modal split. The citys policy choices, with intensive investment in road and public transport infrastructure may explain why short-distance mobility is not as important as it could have been expected in those neighbourhoods with more pedestrian-friendly conditions. The metropolitan transport system is providing mobility conditions, which make far-away destinations attractive to most citizens.

Neighbourhood mobility: a longgone Paradigm? Approaching "proximity" and "land use mix" using data from home-based surveys

Policies trying to increase walking within urban mobility modal split usually highlight the importance of the functional patterns and the environmental quality of the urban space as major drivers of citizens modal choices. Functional characteristics would be mainly associated to an appropriate mix of land uses within neighbourhoods, whereas environmental quality would be associated to the characteristics of urban spaces. The purpose of this research is threefold: first, to identify relevant proxy indicators, which could characterize pedestrian-friendly land use mix and environmental quality. Second, to assess, for both traits, existing disparities among neighbourhoods in a major metropolitan area. And finally, to explore the association between both indicators and children mobility patterns: according to their built environment, which neighbourhoods have a greater proportion of children and, how is their mobility? Using data from the 2004 household mobility survey in the 128 neighbourhoods of the municipality of Madrid, this paper concludes that potentially favourable conditions at the neighbourhood level seem to have only a modest influence in,mobility patterns , in terms of both, selection of closer destinations and a higher share of walking within modal split. The city s policy choices, with intensive investment in road and public transport infrastructure may explain why short-distance mobility is not as important as it could have been expected in those neighbourhoods with more pedestrian-friendly conditions. The metropolitan transport system is providing mobility conditions, which make far-away destinations attractive to most citizens.

Migrant child welfare : a state of the field study of child welfare services for migrant children and their families who are in-stream, home based, or settled-out : executive summary /

"Performed under Contract No. HEW-105-76-1140."

Migrant child welfare : a state of the field study of child welfare services for migrant children and their families who are in-stream, home based, or settled-out : final report /

Performed under contract no. HEW-105-76-1140, National Center for Child Advocacy and prepared by members of InterAmerica Research Associates.

Evaluation of a brief child-focused group-based intervention for anxiety-disordered children

This paper presents a pilot study of a brief, group-based, cognitive-behavioural intervention for anxiety-disordered children. Five children (aged 7 to 13 years) diagnosed with a clinically significant anxiety disorder were treated with a recently developed 6-session, child-focused, cognitive-behavioural intervention that was evaluated using multiple measures (including structured diagnostic interview, self-report questionnaires and behaviour rating scales completed by parents) over four follow-up occasions (posttreatment, 3-month follow-up, 6-month follow-up and 12-month follow-up). This trial aimed to (a) evaluate the conclusion suggested by the research of Cobham, Dadds, and Spence (1998) that anxious children with non-anxious parents require a child-focused intervention only in order to demonstrate sustained clinical gains; and (b) to evaluate a new and more cost-effective child-focused cognitive-behavioural intervention. Unfortunately, the return rate of the questionnaires was poor, rendering this data source of questionable value. However, diagnostic interviews (traditionally the gold standard in terms of outcome in this research area) were completed for all children at all follow-up points. Changes in diagnostic status indicated that meaningful treatment-related gains had been achieved and were maintained over the full follow-up period. The results would thus seem to support the principle of participant-intervention matching proposed by Cobham et al. (1998), as well as the utility of the more brief intervention evaluated.

Parent management training and Asperger syndrome - A randomized controlled trial to evaluate a parent based intervention

This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. The intervention compared two formats, a 1 day workshop and six individual sessions. Measures were taken on three occasions: pre-intervention, at 4 weeks, and at 3 month follow-up. Variables of interest were number and intensity of problem behaviours, and parent evaluation of social interaction skills. Results showed parents reporting fewer and lower intensity of problem behaviours and increased social interactions at 4 weeks and 3 months. Results held across formats and suggest that parent management training can provide an effective intervention for parents of a child with Asperger syndrome. Group differences on outcome measures and in the use of strategies are discussed along with limitations of the study.

A Drug-Based Intervention Study on the Importance of Buffaloes for Human Schistosoma Japonicum Infection around Poyang Lake, People’s Republic of China

Schistosomiasis japonica is a zoonosis of major public health importance in southern China. We undertook a drug intervention to test the hypothesis that buffalo are major reservoirs for human infection in the marshlands/lake areas, where one million people are infected. We compared human and buffalo infection rates and intensity in an intervention village (Jishan), where humans and buffalo were treated with praziquantel, and a control village (Hexi), where only humans were treated, in the Poyang Lake region. Over the four-year study, human incidence in Jishan decreased but increased in Hexi. Adjustment of incidence by age, sex, water exposure, year, and village further confirmed the decreased human infection in Jishan. Chemotherapy for buffaloes resulted in a decrease in buffalo infection rates in Jishan, which coincided with the reduction in human infection rates there in the last two years of the study. Mathematical modeling predicted that buffalo are responsible for 75% of human transmission in Jishan. Copyright © 2006 by The American Society of Tropical Medicine and Hygiene.