A worksite prevention program for construction workers: design of a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers.</p> <p>Methods</p> <p>The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1) two individual training sessions of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted.</p> <p>Discussion</p> <p>The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry.</p> <p>Trial Registration</p> <p>NTR1278</p

Міські проекції в ранній ліриці Лесі Українки

У статті вивчаються особливості художнього осмислення міського простору в ранній ліриці Лесі Українки. Звертається увага на те, що в процесі свого літературного становлення поетеса використала досвід різних традицій. Сентиментально налаштована героїня її творів оцінює місто як меркантильне, нелюдяне, байдуже до природної краси. В окремих поезіях переважає романтичний погляд: міський простір розглядається як тісний і задушливий, такий, що нівелює неповторність окремої особистості. Низка творів авторки репрезентує погодження неокласичних і романтичних тенденцій. Ключові слова: сентименталізм, романтизм, неокласицизм, лірика.В предлагаемой статье исследуются особенности художественного осмысления городского пространства в ранней лирике Леси Украинки. Учитывается тот факт, что в процессе своего литературного становления поэтесса использовала опыт различных традиций. Сентиментально настроенная героиня ее произведений оценивает город как меркантильный, исполненный безразличия к естественной красоте. В отдельных поэзиях преобладает романтический взгляд: городское пространство рассматривается как тесное, нивелирующее неповторимость отдельной личности. Ряд произведений Леси Украинки представляет взаимодействие романтических и неоклассических тенденций. Ключевые слова: сентиментализм, романтизм, неоклассицизм, лирика.In the article the features of early lyric poetry of Lesya Ukrainka are explored. That is taken into account, that in the process of the literary becoming a poetess used experience of different traditions. The sentimentally adjusted heroine gives preference to natural beauty. A romantic look prevails in separate poetries: urbanism space appears as incompatible with the uniqueness of individual. Romantic and neoclassical tendencies co-operate in a number of works of Lesya Ukrainka. Keywords: sentimentalizm, romanticism, neoclassicism, lyric poetry

Effectiveness of an intervention at construction worksites on work engagement, social support, physical workload, and need for recovery: results from a cluster randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>To prolong sustainable healthy working lives of construction workers, a worksite prevention program was developed which aimed to improve the health and work ability of construction workers. The aim of the current study was to investigate the effectiveness of this program on social support at work, work engagement, physical workload and need for recovery.</p> <p>Methods</p> <p>Fifteen departments from six construction companies participated in this cluster randomized controlled trial; 8 departments (n=171 workers) were randomized to an intervention group and 7 departments (n=122 workers) to a control group. The intervention consisted of two individual training sessions of a physical therapist to lower the physical workload, a Rest-Break tool to improve the balance between work and recovery, and two empowerment training sessions to increase the influence of the construction workers at the worksite. Data on work engagement, social support at work, physical workload, and need for recovery were collected at baseline, and at three, six and 12 months after the start of the intervention using questionnaires.</p> <p>Results</p> <p>No differences between the intervention and control group were found for work engagement, social support at work, and need for recovery. At 6 months follow-up, the control group reported a small but statistically significant reduction of physical workload.</p> <p>Conclusion</p> <p>The intervention neither improved social support nor work engagement, nor was it effective in reducing the physical workload and need for recovery among construction workers.</p> <p>Trial registration</p> <p>NTR1278</p

Evaluation of the effects of a training programme for patients with prolonged fatique on physiological parameters and fatique complaints

Objectives: Complaints of prolonged fatigue are considered as a major health problem, as it can affect daily functioning and may lead to work disability. To increase knowledge about the effectiveness of interventions focussing on fatigued patients, a study was designed to evaluate an established training programme for patients with prolonged fatigue. Materials and Methods: Eighteen patients who reported fatigue to be one of their major health complaints and who were suffering from functional impairments attended a training programme of six weeks, three times a week. The training consisted mainly of physical endurance training, relaxation therapy and breathing exercises in rest. At baseline, time- and frequency-domain measures of heart rate variability (HRV) and respiration rate measurements were recorded during rest and during recovery after bicycle exercise. Furthermore, fatigue complaints were assessed with the Checklist Individual Strength (CIS). These measurements were repeated at three weeks and six weeks from baseline. Results: After three weeks, HRV increased significantly in rest - SDNN, i.e. standard deviation of normal beat-to-beat intervals (p = 0.02), very low frequency (p = 0.04) and low frequency (p = 0.04) - and showed a positive trend in the remaining HRV components. No significant HRV changes during recovery were found. Respiration rate decreased significantly after six weeks during rest (from 11.8, SD = 4.65 to 8.1, SD = 2.57 b x min(-1)) and during recovery (from 15.1, SD = 4.90 to 10.4, SD = 2.97 b x min(-1)). In all patients, CIS scores decreased after six weeks training (from 106, SD = 13.3 to 78, SD = 21.8, p = 0.001). Conclusions: The results suggest that a six-week training programme has a beneficial effect on physiological and subjective parameters in patients with severe complaints of fatigu

Intervention mapping as a framework for developing an intervention at the worksite for older construction workers

Purpose. The purpose of this study was to apply the Intervention Mapping approach as a framework in the development of a worksite intervention to improve the work ability of construction workers. Design. Development of an intervention by using the Intervention Mapping approach. Setting. Construction worksite. Participants. Construction workers aged 45 years and older. Measures and Analysis. According to the principles of Intervention Mapping, evidence from the literature was combined with data collected from stakeholders (e.g., construction workers, managers, providers). Results. The Intervention Mapping approach resulted in an intervention with the following components: (1) two individual visits of a physical therapist to lower the physical workload, (2) a Rest-Break tool to improve the balance between work and recovery, and (3) two empowerment training sessions to increase the range of influence at the worksite. Conclusions. Application of Intervention Mapping in the development of a worksite prevention program was useful in the construction industry to obtain a positive attitude and commitment. Stakeholders could give input regarding the program components as well as provide specific leads for the practical intervention strategy. Moreover, it also gives insight in the current theoretical and empirical knowledge in the field of improving the work ability of older workers in the construction industry

Mental health symptoms identify workers at risk of long-term sickness absence due to mental disorders: prospective cohort study with 2-year follow-up

Background: Mental health problems are a leading cause of long-term sickness absence (LTSA). Workers at risk of mental LTSA should preferably be identified before they report sick. The objective of this study was to examine mental health symptoms as predictors of future mental LTSA in non-sicklisted workers. Methods: Prospective cohort study of 4877 non-sicklisted postal workers. Mental health symptoms were measured at baseline in November 2010 with the Four-Dimensional Symptom Questionnaire (distress and depressed mood) and Maslach's Burnout Inventory (fatigue). Mental health symptom scores were analyzed against incident mental LTSA retrieved from an occupational health register in 2011 and 2012. The area under the receiver operating characteristic curve (AUC) represented the ability of mental health symptom scores to discriminate between workers with and without mental LTSA during 2-year follow-up. Results: Complete cases analysis included 2782 (57 %) postal workers of whom 73 had mental LTSA during 2-year follow-up. Distress fairly (AUC = 0.75; 95 % CI 0.67-0.82) and both depressed mood (AUC = 0.64; 95 % CI 0.57-0.72) and fatigue (AUC = 0.61; 95 % CI 0.53-0.69) poorly discriminated between workers with and without mental LTSA during 2-year follow-up. The discriminative ability of distress did not improve by adding depressed mood and fatigue. Conclusions: Measurement of distress sufficed to identify non-sicklisted postal workers at risk of future mental LTSA. The Four-Dimensional Symptom Questionnaire distress scale is a promising tool to screen working populations for of mental LTSA, which enables secondary preventive strategies

Prediction models to identify workers at risk of sick leave due to low-back pain in the Dutch construction industry

Objective The aim of this study was to develop a prediction model based on variables measured in occupational health checks to identify non-sick listed workers at risk of sick leave due to non-specific low-back pain (LBP). Methods This cohort study comprised manual (N=22 648) and non-manual (N=9735) construction workers who participated in occupational health checks between 2010 and 2013. Occupational health check variables were used as potential predictors and LBP sick leave was recorded during 1-year follow-up. The prediction model was developed with logistic regression analysis among the manual construction workers and validated in non-manual construction workers. The performance of the prediction model was evaluated with explained variances (Nagelkerke's R-square), calibration (Hosmer-Lemeshow test), and discrimination (area under the receiver operating curve, AUC) measures. Results During follow-up, 178 (0.79%) manual and 17 (0.17%) non-manual construction workers reported LBP sick leave. Backward selection resulted in a model with pain/stiffness in the back, physician-diagnosed musculoskeletal disorders/injuries, postural physical demands, feeling healthy, vitality, and organization of work as predictor variables. The Nagelkerke's R-square was 3.6%; calibration was adequate, but discrimination was poor (AUC=0.692; 95% CI 0.568-0.815). Conclusions A prediction model based on occupational health check variables does not identify non-sick listed workers at increased risk of LBP sick leave correctly. The model could be used to exclude the workers at the lowest risk on LBP sick leave from costly preventive interventions

Shortened version of the work ability index to identify workers at risk of long-term sickness absence

Background: The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers at risk of LTSA. Methods: Prospective study including two samples of non-sicklisted workers participating in occupational health checks between 2010 and 2012. A heterogeneous development sample (N = 2899) was used to estimate logistic regression coefficients for the complete WAI, a shortened WAI version without the list of diseases, and single-item Work Ability Score (WAS). These three instruments were calibrated for predictions of different (a parts per thousand yen2, a parts per thousand yen4 and a parts per thousand yen6 weeks) LTSA durations in a validation sample of non-sicklisted workers (N = 3049) employed at a steel mill, differentiating between manual (N = 1710) and non-manual (N = 1339) workers. The discriminative ability was investigated by receiver operating characteristic analysis. Results: All three instruments under-predicted the LTSA risks in both manual and non-manual workers. The complete WAI discriminated between individuals at high and low risk of LTSA a parts per thousand yen2, a parts per thousand yen4 and a parts per thousand yen6 weeks in manual and non-manual workers. Risk predictions and discrimination by the shortened WAI without the list of diseases were as good as the complete WAI. The WAS showed poorer discrimination in manual and non-manual workers. Conclusions: The WAI without the list of diseases is a good alternative to the complete WAI to identify non-sicklisted workers at risk of future LTSA durations a parts per thousand yen2, a parts per thousand yen4 and a parts per thousand yen6 weeks.</p