Objectives. We sought to determine the relative effectiveness of different methods of worker safety and health training aimed at improving safety knowledge and performance and reducing negative outcomes (accidents, illnesses, and injuries).Methods. Ninety-five quasi-experimental studies (n=20991) were included in the analysis. Three types of intervention methods were distinguished on the basis of learners’ participation in the training process: least engaging (lecture, pamphlets, videos), moderately engaging (programmed instruction, feedback interventions), and most engaging (training in behavioral modeling, hands-on training).Results. As training methods became more engaging (i.e., requiring trainees’ active participation), workers demonstrated greater knowledge acquisition, and reductions were seen in accidents, illnesses, and injuries. All methods of training produced meaningful behavioral performance improvements.Conclusions. Training involving behavioral modeling, a substantial amount of practice, an...

https://www.uc.edu/content/dam/uc/evaluationservices/MWC/resources/Effective_Safety_Training.pdf

Relative effectiveness of worker safety and health training methods.

STUDY DESIGN This study analyzed two groups of subjects during forward bending. Group 1 (n = 20) contained subjects with a history of low back pain and Group 2 (n = 21) included subjects without a history of low back pain. OBJECTIVE The purposes of this study were to establish the amount and pattern of lumbar spine and hip motion during forward bending, and determine differences in motion in subjects with and without a history of low back pain. SUMMARY OF BACKGROUND DATA Reported values for lumbar spine motion during forward bending vary from 23.9 degrees to 60 degrees and hip motion during forward bending ranges from 26 degrees to 66 degrees. There has been no direct study of both lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain to establish differences in total amounts or pattern of lumbar spine and hip motion during forward bending. METHODS A three-dimensional optoelectric motion analysis system was used to measure the amount and velocity of lumbar spine and hip motion during forward bending. Each subject performed three trials of forward bending that were averaged and used for statistical analysis. Hamstring flexibility was also assessed by two clinical tests, the passive straight leg raising and active knee extension tests. RESULTS Mean total forward bending for all subjects was 111 degrees: 41.6 degrees from the lumbar spine and 69.4 degrees from the hips. There were no group differences for total amounts of lumbar spine and hip motion or velocity during forward bending. The pattern of motion was described by calculating lumbar-to-hip flexion ratios for early (0-30 degrees), middle (30-60 degrees), and late (60-90 degrees) forward bending. For all subjects, mean lumbar-to-hip ratios for early, middle, and late forward bending were 1.9, 0.9, and 0.4, respectively. Therefore, the lumbar spine had a greater contribution to early forward bending, the lumbar spine and hips contributed almost equally to middle forward bending, and the hips had a greater contribution to late forward bending. A t test revealed a difference between groups for the pattern of motion. Group 1 tended to move more at their lumbar spine during early forward bending and had a significantly lower lumbar-to-hip flexion ratio during middle forward bending (P < 0.01). Hamstring flexibility was strongly correlated to motion in subjects with a history of low back pain, but not in healthy subjects. CONCLUSIONS The results provide quantitative data to guide clinical assessment of forward bending motion. Results also suggest that although people with a history of low back pain have amounts of lumbar spine and hip motion during forward bending similar to those of healthy subjects, the pattern of motion is different. It may be desirable to teach patients with a history of low back pain to use more hip motion during early forward bending, and hamstring stretching may be helpful for encouraging earlier hip motion.

Analysis of lumbar spine and hip motion during forward bending in subjects with and without a history of low back pain.

Two case studies are presented to demonstrate that children who experience trauma-related nightmares may benefit from cognitive-behavioral therapy for this sleep problem. The treatment was adapted from the empirically supported adult treatment for chronic trauma-related night- mares: exposure, relaxation, and rescripting therapy (ERRT). Pretreatment and posttreatment nightmare frequency and severity were measured in addition to subjective nightmare-related distress, behavioral problems, sleep quality and quantity, and symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression. Improvement in nightmare and sleep disturbance fre- quencies were found as well as reductions in parents' reports of child behavior problems. This study provides preliminary support for the use of ERRT with children.

A Case Series: Cognitive- Behavioral Treatment (Exposure, Relaxation, and Rescripting Therapy) of Trauma-Related Nightmares Experienced by Children

Ergonomic intervention research for improved musculo-skeletal health: A critical review

Low back disorders (LBDs) continue to be the most common musculoskeletal problem in the workplace. It affects many workers, is associated with high costs to industry and the individual, and can negatively influence the quality of life for the workers. Currently there is significant controversy about the work-relatedness of LBD and the ability of ergonomics interventions to control the problem. This paper systematically examines the body of knowledge associated with LBDs and considers how information from different disciplines of study collectively might be used to assess the causality and control of LBD due to physical factors associated with work.

Occupational low back disorder causation and control.

The aim of this intervention was to evaluate the effect of training on patient-handling skills and prospectively to assess the effect of skill on subsequent back pain and back injuries in nursing. Of a total of 255 nurses, 199 were assessed for their skill in patient-handling. One-half (control group) received traditional training in patient-handling, and the other half (trained group) received a curriculum of instruction totaling 40 hours. The skills of both groups were assessed on graduation. The control group was rated as less competent in patient-handling. Nurses in both groups were questioned about the prevalence of back pain and incidence of back injuries in the first year after graduation. In multiple regression analysis, the major risk indicators for back injuries were poor patient-handling skill, low numbers of repetitions in the sit-up test, and high work-load scores. High score on the hysteria scale of Middlesex Hospital Questionnaire was a risk indicator for all kinds of back pain. Though back pain was independent of patient-handling skill, those rated as "bad" or "poor" had more back injuries (24%) than those who had been rated as "good" or "excellent" (2%) (P less than 0.001), but the difference between the trained and control groups was not statistically significant. It was concluded that back injuries may be prevented by the teaching of patient-handling skills.

H Rauhala

Papers

Patient-handling skill, back injuries, and back pain. An intervention study in nursing.