Musculoskeletal outcomes in children using computers : a model representing the relationships between user correlates, computer exposure and musculoskeletal outcomes

The etiology of musculoskeletal outcomes associated with the use of information technology (IT) has predominately been defined by studies of adults in their work environments. Theories explaining the causation of work related musculoskeletal disorders have identified individual user (biomechanical, physiological and psychosocial), task demand, work organization and environmental risk factors. Models based on these theories have subsequently been developed to investigate the causal relationship between IT exposure and outcomes experienced by the user.Computers are an important IT type used by children, and computer use by children is rapidly growing in both school and home environments. Recent literature demonstrates an increase in children’s reports of computer related musculoskeletal outcomes. Children’s computer use appears to be different to adult’s work related computer use. Thus, although many potential risk factors for children may be similar to those for adults, it is proposed that risk factors and models of causal relationships between computer use and musculoskeletal outcomes may vary for children.The main aims of this study were: (1) to investigate children’s computer exposure in their usual occupational environments of school and home; and (2) to develop and test a multivariable model that would assist in understanding relationships between child user correlates, computer exposure and computer related musculoskeletal outcomes.1351 students (792 boys and 559 girls) from eight primary and five secondary schools in Perth, Australia, participated in the study in 2006. Convenience sampling was undertaken within stratified groups, to ensure the sample had the required range of participants from different socioeconomic status (SES) backgrounds, both genders and school Years 1, 6, 9 and 11(approximate ages 6, 9, 14 and 16 years).The study design was cross sectional involving the completion of a questionnaire survey by participants, and for younger participants their parents. Questionnaires contained items relating to the participant and their activity exposure as an individual, within a family context, and within their neighbourhood. Physical measures of height and weight were also collected.The results showed that 100% of children had access to computers at school, and at home 98.9% of children had access to computers, with 95.9% reporting home internet access. The use of different exposure measures demonstrated that at school 97.8% of children had used a computer in the last month, for an average of 2.4 hours per week, commonly for 30-60 minutes in one sitting. At home 95.7% of children had used a computer in the last month, for an average of 7.2 hours per week, commonly for 60 - 120 minutes in one sitting. Computer activities performed more frequently at school were surfing the internet, learning programs and multimedia. At home the most frequent computer activities were surfing the internet and email. Children with bedroom computer access were found to have nearly 50% greater mean weekly hours of use. The use of a range of computer exposure measures (frequency, usual and longest duration, mean weekly hours and frequency of computer activities) provided better characterization of the amount and nature of children’s school and home computer exposure.Age and gender were associated with children’s school and home computer use. Computer use was greater with age for both boys and girls, and boys had greater use than girls across all Year levels for all exposure measures except school usual duration. Children with greater computer exposure were shown to experience less computer anxiety; reported more somatic complaints; had used a broader range of computer activities; had greater exposure to other IT activities (electronic games, TV, mobile phone) and moderate vigorous physical activity. SES was associated with computer exposure, with children from low SES backgrounds having greater home computer exposure, and children from high SES backgrounds having greater school computer exposure.Computer related musculoskeletal outcomes were reported by 10% of children for school computer use and 20% for home computers. The most commonly affected body locations were the neck and back, and 30% of those children reporting outcomes limited their activity participation, 10% took medication and 7% consulted a treating health professional. The use of a range of outcome measures allowed for a better understanding of the impact of children’s computer related musculoskeletal outcomes.Given the significant findings of different relationships between children’s computer exposure patterns at school and home, two models were developed and tested, with one model for school computer exposure and one model for home computer exposure. Path analysis modeling, accounting for user correlates, tested direct relationships and indirect relationships via computer exposure for a range of user correlates. The final school computer exposure model showed direct relationships between gender, somatic complaints, computer exposure and musculoskeletal soreness; and indirect relationships, via computer exposure, between age, computer flow, TV exposure, SES and musculoskeletal soreness. The final home computer exposure model showed direct relationships between gender, age, somatic complaints, computer exposure and musculoskeletal soreness; and indirect relationships, via computer exposure, between age, computer flow, computer anxiety, TV exposure, SES and musculoskeletal soreness.In conclusion, the child specific model tested within this study demonstrated direct relationships between children’s computer exposure and musculoskeletal outcomes. Additionally, direct and indirect relationships were also shown between a range of user correlates, the environment and musculoskeletal outcomes. These findings will assist researchers, teachers and parents to understand the range of potential risk factors for computer related musculoskeletal outcomes. This will also allow researchers to target interventions to child users and their computer environments to ensure children’s computer use is performed in a safe and productive manner

The impact of eLearning tools on the interprofessional learning experience in a first year foundations health unit

Foundations for Professional Health Practice 100 is a first year first semester unit that was developed for the Faculty of Health Sciences’ interprofessional common first year. To investigate the effectiveness of eLearning tools to assist the students in meeting two of the unit learning outcomes a cross sectional survey was undertaken. Results of the survey demonstrated that most eLearning tools (eg. Blackboard quizzes, wiki, Elluminate Live!, iPortfolio, Turnitin, and vodcasts) were effective in enabling students to achieve one or more of the course learning outcomes. These results show the value of using eLearning tools in first year tertiary courses to enhance student engagement and academic progress

The influence of age, gender and other information technology use on young people's computer use at school and home

Young people are exposed to a range of information technologies (IT) in different environments, including home and school, however the factors influencing IT use at home and school are poorly understood. The aim of this study was to investigate young people's computer exposure patterns at home and school, and related factors such as age, gender and the types of IT used. 1351 children in Years 1, 6, 9 and 11 from 10 schools in metropolitan Western Australia were surveyed. Most children had access to computers at home and school, with computer exposures comparable to TV, reading and writing. Total computer exposure was greater at home than school, and increased with age. Computer activities varied with age and gender and became more social with increased age, at the same time parental involvement reduced. Bedroom computer use was found to result in higher exposure patterns. High use of home and school computers were associated with each other. Associations varied depending on the type of IT exposure measure (frequency, mean weekly hours, usual and longest duration). The frequency and duration of children's computer exposure were associated with a complex interplay of the environment of use, the participant's age and gender and other IT activities

Associations between meeting sleep, physical activity or screen time behaviour guidelines and academic performance in Australian school children

Background: Current guidelines suggest too little sleep, too little physical activity, and too much sedentary time are associated with poor health outcomes. These behaviours may also influence academic performance in school children. The primary purpose of this study was to examine the relationships between sleep, physical activity, or sedentary behaviours and academic performance in a school with a well-developed and integrated technology use and well-being program. Methods: This was a cross-sectional survey of students (n = 934, Grades 5-12) in an Australian school with a bring-your-own device (tablet or laptop computer) policy. Students reported sleep, physical activity, and sedentary (screen and non-screen) behaviours. Academic performance was obtained from school records. Linear regressions were used to test the association between behaviours and academic performance outcomes. Results: Seventy-four percent of students met sleep guidelines (9 to 11 h for children 5-13 years and 8 to 10 h for 14-17 year olds), 21% met physical activity guidelines (60 min of moderate-to-vigorous physical activity every day), and 15% met screen time guidelines (no more than 2 h recreational screen time per day); only 2% met all three. There were no associations between meeting sleep guidelines and academic performance; however later weekend bedtimes were associated with poorer academic performance (- 3.4 points on the Average Academic Index, 95%CI: - 5.0, - 1.7, p <.001). There were no associations between meeting physical activity guidelines and academic performance. Meeting screen guidelines was associated with higher Average Academic Index (5.8, 95%CI: 3.6, 8.0, p <.001), Maths 7.9, 95%CI: 4.1, 11.6, p <.001) and English scores (3.8, 95%CI: 1.8, 5.8, p <.001) and higher time in sedentary behaviours was associated with poorer academic performance, including total sedentary behaviours in hrs/day (5.8 points on Average Academic Index, 95%CI: 3.6, 8.0, p <.001. Meeting at least two of the three behaviour guidelines was associated with better academic performance. Conclusions: Sleep and sedentary behaviours were linked to academic performance. School communities should emphasize comprehensive wellness strategies to address multiple behaviours to maximize student health and academic success

Empowering academics to be adaptive with eLearning technologies: An exploratory case study

© 2019. This paper describes an exploratory case study investigating the capacity of a multidisciplinary approach to academic development, to empower adaptive responses to ongoing technological change impacting on teaching practice. A quasi-experimental design with an intervention group (n = 22) and a comparative control group (n = 7) was adopted. Pre and post online questionnaires were administered to participants in both groups to evaluate attitudes and experiences relating to technology use in teaching and learning. The questionnaires were adapted from the Technology Acceptance Model. Qualitative measurement of the intervention group's experiences following the professional development was captured using semi-structured interviews, followed by two focus groups to confirm the interview findings. Results indicate that the professional development impacted positively on participants through significantly increased levels of confidence and perceived ease of use. Qualitative data indicated participants experienced cognitive, emotional, and/or practical changes during and/or following the professional development

Does the Integration of Telehealth into Occupational Therapy Practice Impact Clinical Outcomes for Hand and Upper Limb Rehabilitation? A Matched Case Control Study

Health services are capitalizing on the rise of telehealth and seeking to develop sustainable models incorporating telehealth into standard care. Further research is required to explore the service and clinical outcomes of telehealth in occupational therapy hand and upper limb practice. This research utilized a case-control study to explore the feasibility and clinical outcomes of case matched patients who received a telehealth hybrid model versus traditional in-person care. One hundred and two patients were recruited (n=51 in the controls and cases) with a mean age of 45 years. Telehealth was not inferior to standard care with no significant increase in therapy time (p=0.441) or length of referral (p=0.047). There was no difference in clinical adverse events (p=0.741). Patients who received telehealth had significantly less withdrawals from the service (p = 0.031). Patient and therapist satisfaction were high, supporting the ongoing use and continued implementation of telehealth in occupational therapy

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

<p>Abstract</p> <p>Background</p> <p>A growing number of countries are introducing some form of nurse prescribing. However, international reviews concerning nurse prescribing are scarce and lack a systematic and theoretical approach. The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labor.</p> <p>Methods</p> <p>A comprehensive search of six literature databases and seven websites was performed without any limitation as to date of publication, language or country. Additionally, experts in the field of nurse prescribing were consulted. A three stage inclusion process, consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by pairs of reviewers. Data were synthesized using narrative and tabular methods.</p> <p>Results</p> <p>One hundred and twenty-four publications met the inclusion criteria. So far, seven Western European and Anglo-Saxon countries have implemented nurse prescribing of medicines, viz., Australia, Canada, Ireland, New Zealand, Sweden, the UK and the USA. The Netherlands and Spain are in the process of introducing nurse prescribing. A diversity of external and internal forces has led to the introduction of nurse prescribing internationally. The legal, educational and organizational conditions under which nurses prescribe medicines vary considerably between countries; from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and supervision of physicians.</p> <p>Conclusions</p> <p>Differences between countries are reflected in the jurisdictional settlements between the nursing and medical professions concerning prescribing. In some countries, nurses share (full) jurisdiction with the medical profession, whereas in other countries nurses prescribe in a subordinate position. In most countries the jurisdiction over prescribing remains predominantly with the medical profession. There seems to be a mechanism linking the jurisdictional settlements between professions with the forces that led to the introduction of nurse prescribing. Forces focussing on efficiency appear to lead to more extensive prescribing rights.</p

Adolescent gender norms and adult health outcomes in the USA: a prospective cohort study.

BACKGROUND: Previous research has documented differences in health behaviours between men and women, with differential risks and health outcomes between the sexes. Although some sex-specific differences in health outcomes are caused by biological factors, many others are socially driven through gender norms. We therefore aimed to assess whether gender expression as an adolescent, determined by the degree to which an individual's behvaiours were typical of their gender, were associated with health behaviours and outcomes in adulthood. METHODS: In this prospective cohort study, we used data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of US adolescents from whom data were collected during adolescence (ages 11-18 years) and adulthood (ages 24-32 years). We created a measure of gender expression that was based on the degree to which male and female adolescents and adults behave in stereotypically masculine (for men) or feminine (for women) ways relative to their same-gender peers. Adolescents were assessed for baseline sociodemographic characteristics and gender expression, and these participants were later assessed, during adulthood, for their gender expression and health behaviours and outcomes, which included depression, self-rated health, drug and alcohol use, cardiovascular risk factors, experience of sexual violence, diet, and obesity. These data were collected via surveys, except for body-mass index, cholesterol, and blood pressure, which were collected as biomarkers. FINDINGS: Between April and December, 1995, self-reported data were collected from 10 480 female and 10 263 male adolescents; similar data were subsequently collected in several waves in this cohort, with a final collection between January, 2008, and February, 2009, when participants were aged 24-32 years. We used data from this final wave and from baseline, and our study represents a secondary analysis of these data. Of these participants, complete follow-up data from 6721 (80%) adult women and 5885 (80%) adult men were available. Gender expression was stable for men and women from adolescence to adulthood. High masculinity (vs low masculinity) in adolescent and adult men was positively associated with smoking in the past month, use of marijuana and recreational drugs, prescription drug misuse (adult gender expression only), and consumption of fast food and soda (adolescent gender expression only) in the past week. However, higher masculine gender expression in adult men was negatively associated with diagnosed depression and high cholesterol in adulthood, and masculine gender expression in adolescent and adult men was negatively associated with high blood pressure in adults. High femininity (vs low femininity) in adolescent or adult women was positively associated with high cholesterol and blood pressure (both adult gender expression only), depression, migraines (adult gender expression only), and physical limitations (ie, health problems that limited their daily activities). However, higher femininity in adolescence was negatively associated with self-rated good health in adulthood. Although feminine gender expression in adolescents was predictive of adult recreational and prescription drug and marijuana use and experience of sexual violence, feminine gender expression in adulthood was negatively associated with adult substance use and experience of sexual violence, suggesting that expressions of femininity typical of adolescents impart risks that expression of femininity as an adult does not. Individuals who are highly masculine or feminine seem to be at greatest risk of adverse health outcomes and behaviours. INTERPRETATION: We found compelling evidence that adolescent gender expression is correlated with health in adulthood independently of gender expression as an adult. Although more research is needed to identify causal mechanisms, our results suggest that those designing health behaviour interventions should carefully consider integrating gender transformative components into interventions. FUNDING: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Gender Equality, Integrated Delivery, HIV, Nutrition, Family Planning, and Water Sanitation and Hygiene Program Strategy Teams (Bill and Melinda Gates Foundation)

Understanding the transmission dynamics of Leishmania donovani to provide robust evidence for interventions to eliminate visceral leishmaniasis in Bihar, India.

Visceral Leishmaniasis (VL) is a neglected vector-borne disease. In India, it is transmitted to humans by Leishmania donovani-infected Phlebotomus argentipes sand flies. In 2005, VL was targeted for elimination by the governments of India, Nepal and Bangladesh by 2015. The elimination strategy consists of rapid case detection, treatment of VL cases and vector control using indoor residual spraying (IRS). However, to achieve sustained elimination of VL, an appropriate post elimination surveillance programme should be designed, and crucial knowledge gaps in vector bionomics, human infection and transmission need to be addressed. This review examines the outstanding knowledge gaps, specifically in the context of Bihar State, India.The knowledge gaps in vector bionomics that will be of immediate benefit to current control operations include better estimates of human biting rates and natural infection rates of P. argentipes, with L. donovani, and how these vary spatially, temporally and in response to IRS. The relative importance of indoor and outdoor transmission, and how P. argentipes disperse, are also unknown. With respect to human transmission it is important to use a range of diagnostic tools to distinguish individuals in endemic communities into those who: 1) are to going to progress to clinical VL, 2) are immune/refractory to infection and 3) have had past exposure to sand flies.It is crucial to keep in mind that close to elimination, and post-elimination, VL cases will become infrequent, so it is vital to define what the surveillance programme should target and how it should be designed to prevent resurgence. Therefore, a better understanding of the transmission dynamics of VL, in particular of how rates of infection in humans and sand flies vary as functions of each other, is required to guide VL elimination efforts and ensure sustained elimination in the Indian subcontinent. By collecting contemporary entomological and human data in the same geographical locations, more precise epidemiological models can be produced. The suite of data collected can also be used to inform the national programme if supplementary vector control tools, in addition to IRS, are required to address the issues of people sleeping outside

They “Miss More Than Anything Their Normal Life Back Home”: Masculinity and Extramarital Sex Among Mexican Migrants in Atlanta

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72531/1/4102309.pd